Relationship between cardiac rhythm disorders, serum urotensin ІІ and angiotensin ІІ levels in patients with stage ii hypertension and carotid atherosclerosis in dynamics of treatment with candesartan and lercanidipine

Authors

  • V. A. Vizir Zaporizhzhia State Medical University,
  • O. V. Demidenko Zaporizhzhia State Medical University,
  • V. V. Shkolovyi Zaporizhzhia State Medical University,

DOI:

https://doi.org/10.14739/2310-1210.2016.5.82546

Keywords:

Hypertension, Arrhythmias, Urotensin II, Angiotensin II, Сandesartan, Lercanidipine

Abstract

Arterial hypertension is one of the most common diseases of the cardiovascular system.

Objective – to study dynamics of cardiac rhythm disorders, serum urotensin II and angiotensin II levels in patients with stage II hypertension associated with carotid atherosclerosis during treatment with candesartan and lercanidipine.

Methods of the study. Under our observation there were 122 patients with stage 2 hypertension aged between 36–75 years. Average age of the patients was 51.52±1.27 years, including men – 52 (43 %), women – 70 (57 %). Cardiac arrhythmias and conduction disorders were detected by means of Holter ECG. Serum urotensin II and angiotensin II levels in the blood serum were determined by use of an immunoenzymatic method. Statistical analysis was performed by means of the Statistica® 6.0 for Windows (StatSoft Inc.) software using parametric and nonparametric methods.

Results. It was found that the receiving of lercanidipine and candesartan showed unidirectional positive effect on cardiac rhythm disorders in most patients with stage II hypertension. The use of candesartan statistically insignificantly increased levels of angiotensin II in patients of the first group of observation by 20.8 % compared with baseline values (p>0.05). However, as a result of candesartan treatment serum angiotensin II levels in patients with stage II hypertension without carotid atherosclerosis reliably increased by 47.1 % (p<0.05). Unlike candesartan, the use of lercanidipine leads to a statistically significant decrease in the concentration of urotensin II by 30.8 % (p<0.05) in patients with stage II hypertension associated with carotid atherosclerosis.

Conclusions. Lercanidipine can be recommended as a first line antihypertensive drug in case of simultaneous hypertension and atherosclerotic lesion of brachiocephalic arteries.

References

Korost, Ya. V., Bula, L.S., & Suprunyuk, V. P. (2014). Osoblyvosti zastosuvannia blokatoriv retseptoriv anhiotenzynu II v likuvanni sertsevo-sudynnoi patolohii [Аdministration Details of ARB II in the Treatment of Cardiovascular Disease]. Liky Ukrainy, 1, 19–23. [in Ukrainian]

Sirenko, Yu. M. (2009). Hipertonichna khvoroba [Hypertension]. Кyiv: Zdorovia. [in Ukrainian]

Guidelines for the management of arterial hypertension (2013). The Task Force for the management of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology. Eur. Heart. J, 28, 1462–1536.

Law, M. R. (2009) Use of blood pressure lowering drugs in the prevention of cardiovascular disease: metaanalysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. B.M.J., 338, 1665–1683. doi: http://dx.doi.org/10.1136/bmj.b1665.

Makarounas-Kirchmann, K., Glover-Koudounas, S., & Ferrari, P. (2009). Results of a meta-analysis comparing the tolerability of lercanidipine and other dihydropyridine calcium channel blockers. Clin Ther., 31, 1652–1663. doi: 10.1016/j.clinthera.2009.08.010.

Wachtell, K., Lehto, M., Gerdts, E., Olsen, M. H., Hornestam, B., Dahlöf, B., et al (2005). Angiotensin II receptor blockade reduces newonset atrial fibrillation and subsequent stroke cmpared to atenolol. The Losartan Intervention for End Point Reduction in Hypertension (LIFE) Study. J Am Coll Cardiol., 45, 712–9. http://dx.doi.org/10.1016/j.jacc.2004.10.068.

Konda, T., Enomoto, A., Aritomi, S., Niinuma, K., Koganei, H., Ogawa, T., & Nitta, K. (2009). Different effects of L/N-type and L-type calcium channel blockers on the renin-angiotensin-aldosterone system in SHR/Izm. Am J Nephrol., 30(2), 155–61. doi: 10.1159/000210396.

Borghi, C. (2005). Lercanidipine in hypertension. Vasc Health Risk Manag., 1(3), 173–82.

Zheng, Z., Shi, H., Jia, J., Li D., & Lin, S. (2011). A systematic review and meta-analysis of candesartan and losartan in the management of essential hypertension. Journal of the Renin-Angiotensin-Aldosterone System, 30(2), 400–408.

Ojima, M., Igata, H., Tanaka, M., Sakamoto, H., Kuroita, T., Kohara, Y., et al. (2011). In vitro antagonistic properties of a new angiotensin type 1 receptor blocker, azilsartan, in receptor binding and function studies. J Pharmacol Exp Ther., 336, 801–808. doi: 10.1124/jpet.110.176636.

Shyu, K.G., Wang, B.W., Chen, W.J., Kuan, P., & Lin, C. M. (2012). Angiotensin II mediates urotensin II expression by hypoxia in cultured cardiac fibroblast. Eur J Clin Invest., 42(1), 17–26. doi: 10.1111/j.1365-2362.2011.02549.x.

Zhang, Y., Bao, S., Kuang, Z., Ma, Y., Hu, Y., & Mao, Y. (2014). Urotensin II promotes monocyte chemoattractant protein-1 expression in aortic adventitial fibroblasts of rat. Chin Med J (Engl), 127(10), 1907–12.

Downloads

How to Cite

1.
Vizir VA, Demidenko OV, Shkolovyi VV. Relationship between cardiac rhythm disorders, serum urotensin ІІ and angiotensin ІІ levels in patients with stage ii hypertension and carotid atherosclerosis in dynamics of treatment with candesartan and lercanidipine. Zaporozhye medical journal [Internet]. 2016Nov.10 [cited 2024Apr.20];18(5). Available from: http://zmj.zsmu.edu.ua/article/view/82546

Issue

Section

Original research