Abstract

BACKGROUND
Antihypertensive agents lower the risk of cardiovascular events, but whether they affect pathways important in inflammation and plaque remodeling in atherosclerosis is uncertain. We assessed whether 2 commonly used antihypertensive agents affected plasma biomarkers reflecting specific inflammatory and remodeling processes over 2 years in the Comparison of Amlodipine versus Enalapril to Limit Occurrences of Thrombosis (CAMELOT) study.
METHODS
The study was a randomized controlled trial of 2 antihypertensives (amlodipine and enalapril) compared with placebo in patients with coronary artery disease and diastolic blood pressure less than 100 mm Hg. In 196 subjects who had baseline and 2-year intravascular coronary ultrasound examinations, we measured plasma interleukin 18, interleukin 1 receptor antagonist, matrix metalloproteinase 9, neopterin, and C-reactive protein. Results for both treatment groups were pooled and compared with placebo.
RESULTS
Antihypertensive treatment with either agent significantly lowered diastolic blood pressure (-4.7 vs placebo 1.3 mm Hg, P = .002) and progression of coronary atheroma (Δ percent atheroma volume 0.6 vs placebo 2.1, P = .031). Antihypertensive therapy did not affect plasma biomarkers of inflammation or plaque remodeling in the 135 subjects with baseline and 2-year biomarker samples. Progression in percent atheroma volume was significantly less in subjects taking statins at baseline (-2.5%, P = .0008).
CONCLUSIONS
In patients with coronary artery disease and well-controlled risk factors, antihypertensive therapy lowered blood pressure and progression of coronary atherosclerosis but did not affect plasma biomarkers of inflammation and remodeling. Antihypertensives may decrease atheroma progression by mechanisms other than those reflected by these plasma biomarkers.

Links

Publisher Full Text

Authors

Zamani P, Ganz P, Libby P, Sutradhar SC, Rifai N, Nicholls SJ, Nissen SE, Kinlay S

Institution

Cardiovascular Division, University of California, San Diego, CA, USA.

Source

American heart journal 163:4 2012 Apr pg 735-40

MeSH

Amlodipine
Antihypertensive Agents
Biological Markers
C-Reactive Protein
Coronary Artery Disease
Coronary Thrombosis
Disease Progression
Enalapril
Humans
Interleukin-18
Matrix Metalloproteinase 9
Neopterin
Receptors, Interleukin-1
Recurrence
Ultrasonography, Interventional

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22520542