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2015, Number 2

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Rev Mex Cardiol 2015; 26 (2)

Regression of carotid intima-media thickness with nifedipine in hypertensive patients

Meaney A, Solache G, Reyes MVM, Gutiérrez-Salmeán G, Ceballos G, Meaney E

Language: English
References: 37
Page: 87-94
PDF size: 231.44 Kb.


ABSTRACT

Background: Calcium channel blockers (CCBs) have proved to reduce both blood pressure levels and cardiovascular outcomes, including the development of atherosclerosis. The INSIGHT study showed a less pronounced progression of carotid intima-media thickness (IMT) in patients treated with nifedipine (NIF) vs. those treated with diuretics, but because IMT was normal in both groups, it was difficult to assess the anti-atherosclerotic effect of NIF. We compared the effect of NIF or hydrochlorothiazide (HCTZ) on atherosclerosis regression in hypertensive patients with abnormally thick IMT. Patients and methods: 37 hypertensive patients were randomly assigned to be treated with slow release-NIF (30 mg) and 46 to HCTZ (25 mg), all of them with IMT › 0.6 mm. IMT, lipid profile, and serum uric acid, potassium, and glucose were analyzed at baseline and 12 months later. Results: Blood pressure was equally well controlled with both treatments. No biochemical abnormality was observed in neither groups. IMT was reduced 35% in the NIF group in comparison to 9.3% in HCTZ group. Discussion: BBCs restore endothelial function, exert antioxidant activity and limit smooth muscle cells growth and proliferation, thus inhibiting fundamental atherogenic phenomena. Our results show a clear regression of IMT, marker of subclinical atherosclerosis with NIF. Conclusion: Both treatments were equally effective reducing blood pressure. HCTZ did not cause metabolic disarrays, but only NIF induced IMT regression. Basal IMT is a main determinant of regression.


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