Clinical Effects of Calcium Channel Blocker and Angiotensin Converting Enzyme Inhibitor on Endothelial Function and Arterial Stiffness in Patients with Angina Pectoris

To evaluate the effects of calcium channel blocker (CCB) and angiotensin converting enzyme inhibitor (ACEI) on endothelial function and arterial stiffness in stable angina pectoris (SAP), 87 patients with SAP (57.6±10.0 yr, 52 males) were divided into two groups; CCB group (group I: n=44, 57.9±9.7 yr, 23 males) vs. CCB plus ACEI group (group II: n=43, 57.2±10.5 yr, 29 males). Flow mediated vasodilation (FMD) of the brachial artery, pulse wave velocity (PWV), urinary albumin excretion (UAE), and high sensitivity C-reactive protein (hsCRP) were compared. FMD, PWV, UAE, and hsCRP were not different between the groups at baseline. After 6 months of treatment, FMD were significantly improved in group II (7.5±3.7 to 8.8±2.7%, p<0.001), but not in group I (7.9±2.7 to 8.2±2.8%, p=0.535). Brachial-ankle PWV were significantly improved in both groups (1,621.3±279.4 to 1,512.1±225.0 cm/sec in group I, p<0.001, 1,586.8±278.5 to 1,434.5±200.5 cm/sec in group II, p<0.001). However, heart-femoral PWV were significantly improved (1,025.7±145.1 to 946.2±112.2 cm/sec, p<0.001) and UAE were significantly decreased (20.19±29.92 to 13.03±16.42 mg/g Cr, p=0.019) in group II only. In conclusion, combination therapy with CCB and ACEI improves endothelial function, arterial stiffness, and UAE than CCB mono-therapy more effectively in patients with SAP.