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      Structure and Function of Small Arteries of Essential Hypertensive Patients Following Chronic Treatment with Once-a-Day Nifedipine

      Cardiology

      S. Karger AG

      Hypertrophy, Atenolol, Nifedipine GITS, Small arteries, Endothelium, Vascular remodeling, Essential hypertension

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          Abstract

          In view of the important impact of small-artery structural and functional abnormalities on complications of hypertension and recent data suggesting that some antihypertensive agents may correct some of these abnormalities, a study of resistance artery structure and function in 20 well-controlled essential hypertensive patients who had received for a prolonged period of time mono-therapy with the once-a-day extended release formulation of the calcium channel antagonist nifedipine (nidefipine GITS) or with the β-blocker atenolol is reviewed. Resistance-size small arteries (standardized lumen diameter of 247 ± 8 µm) were studied after dissection from a gluteal subcutaneous biopsy. Small arteries were investigated on a wire myograph and as pressurized vessels. On the myograph, the media width-to-lumen diameter ratio of arteries was5.37 ± 0.09% in normotensive subjects, 5.38 ± 0.18% in patients treated with nifedipine GITS, 6.81 ± 0.18% in patients treated with atenolol and 7.08 ± 0.12% in untreated hypertensives (p < 0.001, untreated or atenolol-treated patients vs. normotensives or nifedipine-GITS-treated hypertensives), and similar results were found in pressurized arteries. Contractility and endothe-lium-dependent relaxation were impaired in small arteries from untreated or atenolol-treated patients in comparison to those from normotensive subjects or nifedipine-GITS-treated patients. In conclusion, hypertensive patients with well-controlled blood pressure under treatment for more than 1 year with nifedipine GITS exhibit normal structure and function of small arteries, whereas similar patients whose blood pressure is as well controlled by the β-blocker atenolol present abnormally thick small arteries with impaired contractility and endothelium-dependent relaxation. It will be important to determine whether small arteries of other vascular beds are also improved by nifedipine GITS treatment of elevated blood pressure and whether this results in reduced morbidity and mortality in hypertensive patients.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-6620-9
          978-3-318-01632-1
          0008-6312
          1421-9751
          1997
          1997
          19 November 2008
          : 88
          : Suppl 3
          : 20-26
          Affiliations
          MRC Multidisciplinary Research Group on Hypertension, Clinical Research Institute of Montreal, University of Montreal, Canada
          Article
          177502 Cardiology 1997;88:20–26
          10.1159/000177502
          9397289
          © 1997 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 7
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