Effect of the angiotensin receptor blocker valsartan on coronary microvascular flow reserve in moderately hypertensive patients with stable coronary artery disease

Takahiro Higuchi, Claudia Abletshauser, Stephan G. Nekolla, Markus Schwaiger, Frank M. Bengel

Research output: Contribution to journalArticle

Abstract

Aims: To noninvasively investigate the effects of the angiotensin receptor blocker (ARB) Valsartan, on myocardial microcirculation in moderately hypertensive patients with stable coronary artery disease (CAD). Methods and Results: In this prospective open-label study, patients with mild stable CAD and moderate systolic and/or diastolic hypertension were treated with 160 mg Valsartan daily. Myocardial blood flow was quantified noninvasively using positron emission tomography (PET) with N-13 ammonia at baseline, after one week and after 16 weeks. Mean blood pressure at rest improved significantly from baseline to week 16 (105 ± 10 vs. 98 ± 9 mm Hg; p = 0.017, n = 12), but no significant change was observed after one week (103 ± 11 vs. 100 ± 11, p = 0.43, n = 13). PET analysis revealed that flow increase during endothelial-dependent, sympathetic stimulation by cold pressor testing (CPT) and in response to pharmacologic vasodilation with adenosine improved from baseline after 1 week (CPT: 1.10 ± 0.3 vs. 1.37 ± 0.3; p = 0.017, adenosine: 2.34 ± 0.52 vs. 2.91 ± 0.81; p = 0.048) and at week 16 (CPT: 1.15 ± 0.4 vs 1.39 ±0.2; p = 0.10, adenosine: 2.34 ± 0.52 vs 2.81 ± 0.91; p = 0.039). Conclusions: In patients with stable coronary disease, ARB results in improved PET-determined microvascular flow reserve. Improvements in microcirculation preceded the reduction of blood pressure, suggesting direct beneficial effects on microvascular function.

Original languageEnglish (US)
Pages (from-to)805-812
Number of pages8
JournalMicrocirculation
Volume14
Issue number8
DOIs
StatePublished - Nov 2007

Keywords

  • Angiotensin II type 1 receptor blocker
  • Cardiac PET
  • Coronary flow reserve
  • Hypertension
  • Valsartan

ASJC Scopus subject areas

  • Physiology
  • Genetics
  • Cardiology and Cardiovascular Medicine

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