Endothelial dysfunction and arterial stiffness have a prognostic value on adverse long‐term outcomes in coronary artery disease ( CAD) patients. We evaluated the efficacy on vascular reactivity of candesartan and analyzed predictors to control the candesartan's effect on vascular reactivity in CAD patients.
Patients were prospectively enrolled and prescribed candesartan for 6 months. The effect on vascular reactivity was evaluated by the change in flow‐mediated dilation ( FMD) and pulse wave velocity ( PWV).
A total of 124 patients completed the study. The better responder in FMD change (≥1.3%) showed significantly lower baseline FMD than the poor responder ( P < .001). In receiver operating characteristic analysis, baseline FMD 7.5% showed optimal predictive value (sensitivity 79%, specificity 79%) for predicting better responder. The baseline endothelial dysfunction ( FMD <7.5%) was the only significant predictor of the better responder to candesartan. The better responder in PWV change (≤−100 cm/s) showed greater blood pressure lowering and significantly higher baseline PWV than the poor responder (both P < .05). The poor responder in both FMD and PWV showed a higher prevalence of previous myocardial infarction (38.7% vs 17.2%, P = .013).