Why the study?
Does candesartan reduce brachial-ankle pulse wave velocity in type 2 diabetic patients with hypertension compared to calcium channel blockers?
Does candesartan reduce brachial-ankle pulse wave velocity in type 2 diabetic patients with hypertension compared to calcium channel blockers?
Candesartan reduces arterial stiffness (measured by baPWV) in hypertensive patients with type 2 diabetes independently of its blood pressure-lowering effects, suggesting additional vascular benefits.
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Candesartan may reduce arterial stiffness independent of BP lowering in hypertensive T2D patients; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: Hypertension in diabetic patients has been shown to accelerate the progression of atherosclerosis and angiotensin II type-I (AT1) receptor blocker (ARB) has been shown to have anti-atherosclerosis action independent of its action on blood pressure. METHODS AND RESULTS: Type 2 diabetic patients with hypertension received either ARB (candesartan), or a calcium channel blocker (CCB; amlodipine or nifedipine) for 12 weeks. Though clinical parameters such as blood glucose, HbA1c, and systolic and diastolic pressure were not significantly changed between the two groups, brachial-ankle pulse wave velocity (baPWV) was significantly reduced in the candesartan group when compared to CCB groups. Moreover, candesartan treatment exhibited a tendency of reduction in inflammation markers such as high sensitive C-reactive protein (hsCRP) and interleukin-6 (IL-6). CONCLUSION: We conclude that candesartan may improve vascular inflammation independent of its effect on hypertension in diabetes, thus suggesting its efficacy in diabetic patients.
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Ishii et al. (2008) studied this question.
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