ARB Vascular Endothelial Function In Patients With Essential Hypertension

Objectives:By comparing the AT1 receptor antagonist valsartan and calcium channel blocker amlodipine, to further understand the ARB drugs more reverse damaged endothelial function of patients with high blood pressure.Methods:Selection in June 2014 to July 2014 in the second hospital of shanxi medical university do not take any antihypertensive drugs of fifty-two mild to moderate hypertentive patients were randomly assigned to valsartan( 80 mg/ d, n= 26)or amlodipine( 5mg/d, n= 34) and treated to 80- 160 mg valsartan or 5-10 mg amlodipine to achieve goal BP( <140/90 mm Hg). Brachial artery endothelium- dependent dilation function( FMD) was determined by high resolution ultrasonography. nitricoxide(NO) and Endothelin-1(ET-1) were determined before and after 16 wks therapy. Choose age matched normal persons as control group, only test once the above indicators.Results:1.There was no statistically significant difference in gender, age, body mass index(bmi), blood glucose, blood lipids, smoking, heart rate etc in all subjects(P > 0.05).Two groups of patients with hypertension after antihypertensive treatment of 16 blood pressure were significantly decreased in both groups with similar magnitude of reduction(P <0.01),. and blood pressure to drop degree has no statistical significance(P > 0.05);2.Before treatment, two groups of patients with high blood pressure caused byreactive hyperemia changes in brachial artery diameter than the control group decreased significantly(P < 0.05), NO concentrations were significantly lower than the control group(P < 0.01), the concentration of ET 1 level was significantly higher than that of control group(P < 0.01), but the above three indicators differences between two groups of patients with high blood pressure had NO statistical significance(P > 0.05);3.16 weeks after treatment,Although both valsartan and amlodipine increased NO and FMD and decreased ET-1( P < 0.01), however the extent of decrease in ET-1 and increase in NO and FMD was significantly higher in valsartan group.Conclusions:1.In patients with mild-to-moderate essential hypertension FMD relatively less than control, NO concentration levels, concentration of ET 1 levels, which suggests that there may have occurred endothelial dysfunction with mild-to-moderate essential hypertension.2.16 weeks after treatment, FMD, NO and ET- 1 the indicators were improved than before treatment. pertaining to the valsartan and ammonia chloride average can be improved on the basis of the effective step-down impaired endothelial function.3.Both valsartan and amlodipine are effective to reduce blood pressure, improve endothelial function and reduce ET-1 and increase NO. However valsartan has been shown a much greater effect on improvement of endothelial functon and reduction of ET-1 and increment of NO than amlodipine with similar magnitude of reduction.