Differential Effects of Calcium-Channel Blockers on Vascular Endothelial Function in Patients With Coronary Spastic Angina

• DOI: 10.1253/circj.cj-08-0188
• Publication Date: 2009-03-25T05:55:59Z
• Authors: Yoichi Miwa; Hiroyuki Masai; Masatoshi Shimizu
• Keywords: Male; Dihydropyridines; Coronary Vasospasm; Blood Pressure; Middle Aged; Calcium Channel Blockers; 3. Good health; Vasodilation; Diltiazem; 03 medical and health sciences; 0302 clinical medicine; Verapamil; Humans; Female; Endothelium, Vascular; Aged

Background: The effects of the 3 classes L-type calcium-channel blockers (CCBs) on vascular endothelial function have not been clarified in patients with coronary vasospasm. Methods and Results: Twenty-five normotensive (age 64.0±1.4 years) vasospasm were randomly treated for months benidipine, diltiazem, verapamil, which belong to dihydropyridine, benzothiazepine, phenylalkylamine CCBs, respectively. Endothelium-dependent flow-mediated dilatation (FMD), endothelium-independent nitroglycerin-induced brachial arteries, plasma cyclic guanosine 3',5'-monophosphate (cGMP), a nitric-oxide-related product, assessed before after treatment. At baseline, had significantly lower FMD as compared normal subjects (n=8). Blood pressure did differ among groups Benidipine increased (from 4.7±0.6 7.4±1.1%, P<0.05) cGMP levels. In contrast, neither diltiazem nor verapamil affected None treatments dilatation. Conclusions: Benidipine, but or improves dysfunction beyond blood lowering Upregulation nitric oxide - system by benidipine may partly contribute improvement. dihydropyridine class be more beneficial than non-dihydropyridine CCBs. (Circ J 2009; 73: 713 717)