Effects of Valsartan on Endothelial Function in Essential Hypertension Patients with Atrial Fibrillation

Objective Compare the effects of valsartan and amlodipine on endothelial function and inflammation marker in elderly hypertention patients with permanent atrial fibrillation (AF). Methods Sixty-four elderly mild to moderate hypertentive patients with permanent AF were randomly assigned to valsartan (80 mg/d, n=34) or amlodipine(5 mg/d, n=34) and treated to 80-160 mg valsartan or 5-10 mg amlodipine to achieve goal BP(140/90 mm Hg). von Willebrand factor(vWF), nitric oxide (NO) and C reactive protein (CRP) were determined before and after 12 wks therapy. 20 age-matched essential hypertention patients with sinus rhythm served as controls. Results BP were significantly decreased in both groups with similar magnitude of reduction. NO was lower, vWF and CRP were higher in patients with hypertension complicated with AF(P0.01). Although both valsartan and amlodipine increased NO and decreased vWF and CRP(P0.01), however the extent of decrease in vWF and CRP and increase in NO was significantly higher in valsartan group. Conclusion Both valsartan and amlodipine are effective to reduce blood pressure, improve endothelial function and reduce CRP. However valsartan has been shown a much greater effect on improvement of endothelial functon and reduction of inflammatory marker than amlodipine. This finding may be important in the prevention of stroke in elderly hypertentive patients with atrial fibrillation.