Korean J Med.  2001 Nov;61(5):518-526.

Improvement in endothelial function by calcium antagonist and vitamin C in essential hypertension

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 2Division of Cardiology, Department of Internal Medicine,Seoul National University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND: The effects of antihypertensive agents on endothelial function have not been fully evaluated in human hypertension and data on the forearm circulation of humans are controversial. The aim of this study was 1) to evaluate the endothelial function in hypertensive patients 2) to investigate whether vitamin C administration has any benefit on the endothelial function and 3) to determine whether treatment with calcium antagonist improves endothelial dysfunction in hypertensive patients.
METHODS
The endothelial function was estimated using venous occlusion plethysmography (VOP) in 8 hypertensive patients and 8 healthy volunteers. The patients in the hypertension group were treated with amlodipine, then examined again. The change of forearm blood flow (FBF) was measured with acetylcholine infusion through brachial artery and also with intra-arterial vitamin C.
RESULTS
Forearm blood flow response to acetylcholine was significantly enhanced with intra-arterial infusion of vitamin C in hypertensive group before antihypertensive treatment. Co-infusion of L-NMMA, an inhibitor of nitric oxide synthase, blunted forearm blood flow response to acetylcholine. After treatment with amlodipine for 2 months in hypertensive group, endothelium- dependent vasorelaxation to acetylcholine was significantly improved compared to pretreatment, and vitamin C did not affect the improved endothelial function by amlodipine treatment.
CONCLUSION
Vitamin C (acutely) and amlodipine (chronically) improved endothelial function in hypertensive patients. These results suggest that increased oxidative stress, at least in part, may be involved in the decreased endothelial function in hypertension.

Keyword

Plethysmography; Endothelium; Hypertension; Ascorbic acid; Calcium antagonist

MeSH Terms

Acetylcholine
Amlodipine
Antihypertensive Agents
Ascorbic Acid*
Brachial Artery
Calcium*
Endothelium
Forearm
Healthy Volunteers
Humans
Hypertension*
Infusions, Intra-Arterial
Nitric Oxide Synthase
omega-N-Methylarginine
Oxidative Stress
Plethysmography
Vasodilation
Vitamins*
Acetylcholine
Amlodipine
Antihypertensive Agents
Ascorbic Acid
Calcium
Nitric Oxide Synthase
Vitamins
omega-N-Methylarginine
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