Effect of Candesartan on the Hypertensive Organ Damages

Objective: Several mega-trials indicated Angiotensin II receptor antagonist (ARB) protect hypertensive organ damages. We studied the long-term efficacy of ARB (Candesartan) in hypertensive patients with focusing on the target organ damages (TOD). Method: Fifty-three untreated hypertensive patients were enrolled. Mean age was 63.4 years. After the informed-consents, the risk factors and the TOD markers, such as serum high sensitive (hs)-CRP, BNP, urine albumine index and HOMA-R were evaluated, and Candesartan (4-8mg/ day) was started, then these markers were re-evaluated at 12months. The responder was created to 140/90mmHg or reductions of both systolic (SBP) 20mmHg and diastolic (DBP) 10mmHg. Result: The responder rate was 75.5% (40/53), and the mean reductions of SBP and DBP were 15mmHg (153 and 138, p 0.0001) and 5 (87 and 82, p 0.001), respectively. In the some of TOD markers, delta BNP was significantly correlated to the both delta SBP (p 0.05) and delta DBP (p 0.01). The hs-CRP was tended to decrease, and its reduction was dependent on the DBP reduction. Serum uric acid (6.1mg/dl and 5.8, p 0.02) and urine albumine index (26.7mg/g Cr and 17.8, p 0.02) were significantly decreased. Adverse effects, such as cardiovascular events, were observed in 2 cases. Conclusion: It was concluded that Candesartan treatment might be an effective strategy for not only BP lowering but also for some organ protections.