Effect of Amlodipine-Diltiazem Hydrochloride Sustained Release Capsule Combination Therapy on Vascular Endothelial Function in Hypertensive Patients

Objective To study the effect of amlodipine-sustained release diltiazem hydrochloride combination therapy on vascular endothelial function in hypertensive patients.Methods One hundred and eleven hypertensive patients were randomly assigned to receive amlodipine(5-10 mg,qd)-diltiazem hydrochloride sustained release capsule(90 mg,qd,n=56) or amlodipine alone(5-10 mg,qd,n=55).Endothelium dependent vascular flow mediated dilatation(FMD) in brachial artery were assessed by high-resolution-ultrasound technique before and after 12 months treatment,endothelin-1(ET-1) and nitric oxide(NO) were determined.Results After 12 months treatment,compared with before treatment,ET-1 was significantly decreased with NO level increased.Combined treatement accentuated FMD more markedly than amlodipine alone [amlodipine group,before treatment:(7.3±1.9)% vs after treatment:(9.6±2.2)%;combination group,before teatment:(7.4±2.0)% vs after treatment:(11.1±2.3)%,(P0.05).After adjustment for age,BP,blood lipid and blood glucose,multiple linear stepwise regression analysis shown ET-1 and NO were the determinants for FMD(all P0.05).Conclusion Amlodipine and sustained released-diltiazem hydrochloride combination therapy significantly improved vascular endothelial function than that by amlodipine treatment alone,associated with more pronounced antihypertensive effect and greater decreases in serum ET-1 and increases in serum NO.