PS 14-37 ELASTIC PROPERTIES OF THE VASCULAR WALL AND ENDOTHELIAL FUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND CORONARY ARTERY DISEASE, EFFECT OF FELODIPINE AND PERINDOPRIL

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Abstract

Objective:

To study parameters of vascular elasticity using pulse wave velocity (PWV) and endothelial function measurements in patients with arterial hypertension (AH) combined with coronary artery disease (CAD) and to assess possibility of correction of the detected pathology by Felodipine and Perindopril.

Design and Method:

97 subjects were studied: 80 patients with AH and CHD were randomized into 2 groups (40 patients (group 1) received Felodipine, 40 patients (group 2) - Perindopril) and 17 healthy volunteers. 24-hour monitoring of blood pressure (BPM), endothelial dependent vasodilatation (EDV) and endothelium independent vasodilatation (EIV), parameters of vascular elasticity using PWV for elastic and muscular type vessels, level of C-reactive protein (hsCRP) and nitrites were evaluated initially and after 8 weeks of therapy. Healthy volunteers underwent only PWV.

Results:

Initially PWV and coefficient of elasticity for elastic type arteries was significantly higher in patients with AH and CAD than in healthy subjects. EDV and EIV was impaired in patients with AH and CAD. There was found significant correlation between EDV, PWV and the level of systolic blood pressure (BP) (r = −0.42; p < 0.05), pulse BP (r = −0.47; p < 0.01). Antihypertensive effect of both drugs was identical. Felodipine and Perindopril augmented significantly EDV and decreased PWV and coefficient of elasticity for elastic type arteries. After 8 weeks in group 1 the level of nitrites was increased. Changes in EIV and hsCRP level was not detected during treatment.

Conclusions:

In patients with AH and CAD endothelium dysfunction and elastic properties of the vascular wall are associated with data of BPM (systolic BP and pulse BP). Felodipine not only has an antihypertensive effect but improves endothelial function and arterial elasticity, which is comparable with the effect of Perindopril.

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