gms | German Medical Science

28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

24. bis 27.11.2004, Hannover

AT-II-Antagonist is more effective than ACE-inhibitor on arterial pressure during exercise in hypertensive subjects

AT-II-Antagonist senkt den Belastungsblutdruck stärker als ACE-Hemmer

Meeting Abstract (Hypertonie 2004)

Suche in Medline nach

  • R.G. Ketelhut - Humboldt-Universität (Berlin, D)
  • I.-W. Franz - Klinik Wehrawald (Todtmoos, D)

Hypertonie 2004. 28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Hannover, 24.-27.11.2004. Düsseldorf, Köln: German Medical Science; 2005. Doc04hochP104

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Veröffentlicht: 10. August 2005

© 2005 Ketelhut et al.
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Background: Since exemplified in long-term studies that blood pressure (BP) response to exercise proved to be a risk factor independent of resting BP for future cardiovascular morbidity and mortality, a study was designed to compare the efficacy of an AT-II-antagonist and an ACE- inhibitor not only on BP at rest but particularly on BP during standardized exercise testing.

Methods: In 12 previously untreated hypertensives (aged 54±4 years, 3 female) BP was measured at rest, during standardized ergometric exercise (50-100 watts, increments 10 watts/min) and at rest after exercise before and after antihypertensive therapy. Subjects received either 16mg Candesartan or 10mg Ramipril once daily for 6 weeks in a crossover design with a 2 week drop-out between the two treatment periods.

Results: Both candesartan and ramipril provided significant (p<0.001) and almost identical reductions in BP at rest before and after exercise as well. In contrast, during exercise at the workload of 100 watts) Candesartan was more effective in reducing both systolic and diastolic BP from 231±18/111±12 mmHg before therapy to 199±18/98±17mmHg (p<0.001; -14% / -12%) when compared with Ramipril (211±20/105±18mmHg (p<0.01; -9% / -5%). This favorable effect due to the AT-II-antagonist could also be demonstrated for the the rate-pressure-product at a workload of 100 watts (Candesartan: -19%, p<0.001; Ramipril: -13%, p<0.01).

Conclusion: The AT-II-antagonist Candesartan is significantly more effective in reducing BP during exercise than the ACE-inhibitor Ramipril. This is also true for the rate-pressure-product, which reflects the level of myocardial oxygen consumption during exercise. Therefore the AT-II-antagonist should be preferred in physically active hypertensives and cardiac patients such as with contraindication for a beta-blocker therapy.