Cardiovascular Diseases

Differential Effect of BP-Lowering Agents on Microvascular Function

A multicenter, open-label, randomized crossover trial with blinded endpoint assessment in Europe revealed that 4 weeks of treatment with amlodipine, losartan, or atenolol resulted in differential effects on cerebrovascular reactivity (CVR) in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) but not in patients with symptomatic sporadic small vessel disease. The trial enrolled 75 patients with sporadic small vessel disease (mean age 64·9 years) and 26 with CADASIL (53·1 years) between Feb 22, 2018, and April 28, 2022. The primary efficacy analysis included 62 with sporadic small vessel disease and 17 with CADASIL. There was significant difference in CVR between study drugs in patients with CADASIL (15·7 × 10–4%/mm Hg for amlodipine; 19·4 × 10–4%/mm Hg for losartan; –23·9 × 10–4%/mm Hg for atenolol), but not in patients with sporadic small vessel disease (mean change in CVR 1·8 × 10–4%/mm Hg for amlodipine; 16·7 × 10–4%/mm Hg for losartan; –7·1 × 10–4%/mm Hg for atenolol). However, CVR improved with both amlodipine and losartan compared with atenolol in an exploratory subgroup analysis in young sporadic patients using the median split of the study population (age 60 years) as a cutoff. In patients with CADASIL, pairwise comparisons showed that CVR improved with amlodipine compared with atenolol (–39·6 × 10–4%/mm Hg and with losartan compared with atenolol (–43·3 × 10–4%/mm Hg). No deaths or study drug related serious adverse events occurred. CVR declines with ageing and is associated with an increased risk of stroke and death. Source: https://www.thelancet.com/

hyangiu

Recent Posts

4:3 Intermittent Fasting Outperforms Daily Caloric Restriction for Weight Loss

A U.S. randomized clinical trial found that 4:3 intermittent fasting (IMF) led to slightly greater…

1 day ago

Comparative CVD Efficacy of Newer Glucose-Lowering Drugs in Elderly T2D Patients

A Danish nationwide cohort study provided real world evidence that both glucagon-like peptide 1 receptor…

6 days ago

Efficacy of Non-Surgical and Non-Interventional Treatments in Low Back Pain

A systematic review and meta-analysis of placebo-controlled randomized trials showed that there is moderate certainty…

2 weeks ago

Statin Use Linked to Lower Risks of HCC and Liver Disease Progression

A US cohort study indicated that statin use may reduce the risks of hepatocellular carcinoma…

2 weeks ago

Clinical Significance of Carotid Artery Plaque with Age and Sex

A US cohort study suggests that carotid artery plaque (CAP) becomes very common with increasing…

3 weeks ago

Substituting Butter with Plant-Based Oils May Improve Survival

A prospective US population-based cohort study suggested that higher intake of butter was associated with…

4 weeks ago

This website uses cookies.