Login Register Cart 0
Generic placeholder image

Current Medicinal Chemistry

Editor-in-Chief

ISSN (Print): 0929-8673
ISSN (Online): 1875-533X

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe Translate in Chinese
Systematic Review Article

Calcium Channel Blockers in Restoration of Endothelial Function: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author(s): Miroslav Radenković*, Marko Stojanović and Milica Prostran

Volume 26, Issue 29, 2019

Page: [5579 - 5595] Pages: 17

DOI: 10.2174/0929867325666180713144806

Price: $65

Abstract

Background: Clinical evaluation of the Endothelial Function (EF) is becoming an essential step in the quality assessment of cardiovascular risk prevention and rational pharmacotherapy of cardiovascular disorders. The existing pieces of evidence suggested that Calcium Channel Blockers (CCB) can induce positive effects on impaired EF.

Objective: To evaluate the effects of CCB on EF, we performed a meta-analysis of available data from randomized and placebo-controlled or other treatment-controlled clinical studies encompassing effects of CCB on EF, as measured by Flow-Mediated Dilation (FMD) of the brachial artery.

Methods: The relevant clinical studies were searched by systematic exploration of the appropriate databases until November 30, 2017. A random-effect model was conducted. The primary outcome was the percentage change in FMD between the baseline and the final levels in response to investigated drugs.

Results: Fifteen randomized clinical studies with 33 arms were identified. CCB improved FMD more pronounced than thiazide diuretics - TD (3 studies, 157 participants, WMD=2.08%, 95% CI=0.35-3.80%; P=0.02). Oppositely, ACE Inhibitors (ACEI) and Angiotensin Receptor Blockers (ARB) notably improved FMD if compared to CCB (CCB vs. ACEI: 5 studies, 533 participants, WMD = ‐1.62%, 95% CI = ‐2.74% to ‐0.50%; P=0.005; and CCB vs. ARB: 9 studies, 669 participants, WMD = ‐1.52%, 95% CI = ‐2.22% to ‐0.81%; P=0.0001). CCB effects on EF were similar to those evoked by beta blockers or placebo.

Conclusion: CCB improved EF to a more prominent extent only if paralleled to TD, while inversely; ACEI and ARB were more effective in augmenting FMD.

Keywords: Calcium channel blockers, endothelial dysfunction, flow-mediated dilation, meta-analysis, systematic review, cardiovascular risk prevention, rational pharmacotherapy.

« Previous
[1]
Wang, Y.C.; Hsieh, T.C.; Chou, C.L.; Wu, J.L.; Fang, T.C. Calcium channel blockers. Medicine (Baltimore), 2016, 95(2)e2487
[http://dx.doi.org/10.1097/MD.0000000000002487] [PMID: 26765458]
[2]
Gao, B.; Zhang, Z.; Qian, J.; Cao, C.; Hua, X.; Chu, M.; He, X.; Zeng, H. The Use of calcium channel blockers in the treatment of coronary spasm and atrioventricular block. Cell Biochem. Biophys., 2015, 72(2), 527-531.
[http://dx.doi.org/10.1007/s12013-014-0498-z] [PMID: 25572060]
[3]
Nalwaya, R.; Sahai, A.; Chander, S.; Sharma, M.; Malik, R.; Sarsodia, G. Synthesis, characterization, and pharmacological evaluation of benzothiopyran derivatives as a novel class of calcium channel blockers. Med. Chem. Res., 2013, 22(5), 2188-2195.
[http://dx.doi.org/10.1007/s00044-012-0211-y]
[4]
Tocci, G.; Battistoni, A.; Passerini, J.; Musumeci, M.B.; Francia, P.; Ferrucci, A.; Volpe, M. Calcium channel blockers and hypertension. J. Cardiovasc. Pharmacol. Ther., 2015, 20(2), 121-130.
[http://dx.doi.org/10.1177/1074248414555403] [PMID: 25398848]
[5]
Shields, D.L. Calcium channel blockers as initial therapeutic agents in hypertension: relationship to incident heart failure. Biol. Res. Nurs., 2014, 16(3), 266-277.
[http://dx.doi.org/10.1177/1099800413494760]
[6]
Preston Mason, R. Pleiotropic effects of calcium channel blockers. Curr. Hypertens. Rep., 2012, 14(4), 293-303.
[http://dx.doi.org/10.1007/s11906-012-0269-4] [PMID: 22610475]
[7]
Fukao, K.; Shimada, K.; Hiki, M.; Kiyanagi, T.; Hirose, K.; Kume, A.; Ohsaka, H.; Matsumori, R.; Kurata, T.; Miyazaki, T.; Daida, H. Effects of calcium channel blockers on glucose tolerance, inflammatory state, and circulating progenitor cells in non-diabetic patients with essential hypertension: a comparative study between azelnidipine and amlodipine on glucose tolerance and endothelial function--a crossover trial (AGENT). Cardiovasc. Diabetol., 2011, 10, 79.
[http://dx.doi.org/10.1186/1475-2840-10-79] [PMID: 21906391]
[8]
Perez-Reyes, E. Molecular physiology of low-voltage-activated t-type calcium channels. Physiol. Rev., 2003, 83(1), 117-161.
[http://dx.doi.org/10.1152/physrev.00018.2002] [PMID: 12506128]
[9]
Brovkovych, V.; Kalinowski, L.; Muller-Peddinghaus, R.; Malinski, T. Synergistic antihypertensive effects of nifedipine on endothelium: concurrent release of NO and scavenging of superoxide. Hypertension, 2001, 37(1), 34-39.
[http://dx.doi.org/10.1161/01.HYP.37.1.34] [PMID: 11208753]
[10]
Kobayashi, N.; Yanaka, H.; Tojo, A.; Kobayashi, K.; Matsuoka, H. Effects of amlodipine on nitric oxide synthase mRNA expression and coronary microcirculation in prolonged nitric oxide blockade-induced hypertensive rats. J. Cardiovasc. Pharmacol., 1999, 34(2), 173-181.
[http://dx.doi.org/10.1097/00005344-199908000-00001] [PMID: 10445667]
[11]
Su, J.B. Vascular endothelial dysfunction and pharmacological treatment. World J. Cardiol., 2015, 7(11), 719-741.
[http://dx.doi.org/10.4330/wjc.v7.i11.719] [PMID: 26635921]
[12]
Yasu, T.; Kobayashi, M.; Mutoh, A.; Yamakawa, K.; Momomura, S.; Ueda, S. Dihydropyridine calcium channel blockers inhibit non-esterified-fatty-acid-induced endothelial and rheological dysfunction. Clin. Sci. (Lond.), 2013, 125(5), 247-255.
[http://dx.doi.org/10.1042/CS20120311] [PMID: 23535137]
[13]
Yamamoto, E.; Kataoka, K.; Dong, Y.F.; Koibuchi, N.; Toyama, K.; Sueta, D.; Katayama, T.; Yasuda, O.; Ogawa, H.; Kim-Mitsuyama, S. Calcium channel blockers, more than diuretics, enhance vascular protective effects of angiotensin receptor blockers in salt-loaded hypertensive rats. PLoS One, 2012, 7(6)e39162
[http://dx.doi.org/10.1371/journal.pone.0039162] [PMID: 22720058]
[14]
Okamura, T.; Tawa, M.; Geddawy, A.; Shimosato, T.; Iwasaki, H.; Shintaku, H.; Yoshida, Y.; Masada, M.; Shinozaki, K.; Imamura, T. Effects of atorvastatin, amlodipine, and their combination on vascular dysfunction in insulin-resistant rats. J. Pharmacol. Sci., 2014, 124(1), 76-85.
[http://dx.doi.org/10.1254/jphs.13178FP] [PMID: 24389820]
[15]
Kubota, N.; Miyauchi, K.; Kasai, T.; Iesaki, T.; Kajimoto, K.; Sumiyoshi, K.; Dohi, T.; Daida, H. Synergistic effects of calcium-channel and angiotensin-receptor blockers on endothelial function and inflammatory responses in a porcine drug-eluting stent model. Circ. J., 2010, 74(8), 1704-1710.
[http://dx.doi.org/10.1253/circj.CJ-09-0743] [PMID: 20595778]
[16]
Taddei, S.; Virdis, A.; Ghiadoni, L.; Magagna, A.; Favilla, S.; Pompella, A.; Salvetti, A. Restoration of nitric oxide availability after calcium antagonist treatment in essential hypertension. Hypertension, 2001, 37(3), 943-948.
[http://dx.doi.org/10.1161/01.HYP.37.3.943] [PMID: 11244022]
[17]
ENCORE Investigators. Effect of nifedipine and cerivastatin on coronary endothelial function in patients with coronary artery disease: the ENCORE I Study (Evaluation of Nifedipine and Cerivastatin On Recovery of coronary Endothelial function). Circulation, 2003, 107(3), 422-428.
[http://dx.doi.org/10.1161/01.CIR.0000046488.52939.BF] [PMID: 12551866]
[18]
Lüscher, T.F.; Pieper, M.; Tendera, M.; Vrolix, M.; Rutsch, W.; van den Branden, F.; Gil, R.; Bischoff, K.O.; Haude, M.; Fischer, D.; Meinertz, T.; Münzel, T. A randomized placebo-controlled study on the effect of nifedipine on coronary endothelial function and plaque formation in patients with coronary artery disease: the ENCORE II study. Eur. Heart J., 2009, 30(13), 1590-1597.
[http://dx.doi.org/10.1093/eurheartj/ehp151] [PMID: 19474053]
[19]
De Ciuceis, C.; Rossini, C.; Tincani, A.; Airò, P.; Scarsi, M.; Agabiti-Rosei, C.; Ruggeri, G.; Caimi, L.; Ricotta, D.; Agabiti-Rosei, E.; Rizzoni, D. Effect of antihypertensive treatment with lercanidipine on endothelial progenitor cells and inflammation in patients with mild to moderate essential hypertension. Blood Press., 2016, 25(6), 337-343.
[http://dx.doi.org/10.1080/08037051.2016.1184495] [PMID: 27195656]
[20]
Clunn, G.F.; Sever, P.S.; Hughes, A.D. Calcium channel regulation in vascular smooth muscle cells: synergistic effects of statins and calcium channel blockers. Int. J. Cardiol., 2010, 139(1), 2-6.
[http://dx.doi.org/10.1016/j.ijcard.2009.05.019] [PMID: 19523699]
[21]
Mizuno, Y.; Jacob, R.F.; Mason, R.P. Effects of calcium channel and renin-angiotensin system blockade on intravascular and neurohormonal mechanisms of hypertensive vascular disease. Am. J. Hypertens., 2008, 21(10), 1076-1085.
[http://dx.doi.org/10.1038/ajh.2008.258] [PMID: 18756260]
[22]
Mason, R.P.; Kubant, R.; Heeba, G.; Jacob, R.F.; Day, C.A.; Medlin, Y.S.; Funovics, P.; Malinski, T. Synergistic effect of amlodipine and atorvastatin in reversing LDL-induced endothelial dysfunction. Pharm. Res., 2008, 25(8), 1798-1806.
[http://dx.doi.org/10.1007/s11095-007-9491-1] [PMID: 18087679]
[23]
Xin-Ke, Z.; Ming-Xia, F.; Ai-ling, Q.; Kai, L.; Xu, Z.; Ying-dong, L. Amlodipine/atorvastatin has an effect on vascular function and normal lipid levels. Biomed. Res. (Aligarh), 2017, 28(9), 3821-3825.
[24]
Radenković, M.; Stojanović, M.; Potpara, T.; Prostran, M. Therapeutic approach in the improvement of endothelial dysfunction: the current state of the art. BioMed Res. Int., 2013, 2013252158
[http://dx.doi.org/10.1155/2013/252158] [PMID: 23509696]
[25]
Thijssen, D.H.; Black, M.A.; Pyke, K.E.; Padilla, J.; Atkinson, G.; Harris, R.A.; Parker, B.; Widlansky, M.E.; Tschakovsky, M.E.; Green, D.J. Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am. J. Physiol. Heart Circ. Physiol., 2001, 300(1), H2-H12.
[26]
Stojanović, M.; Radenković, M. Vitamin D versus placebo in improvement of endothelial dysfunction: a meta-analysis of randomized clinical trials. Cardiovasc. Ther., 2015, 33(3), 145-154.
[http://dx.doi.org/10.1111/1755-5922.12122] [PMID: 25850709]
[27]
Stojanović, M.; Prostran, M.; Radenković, M. Thiazolidinediones improve flow-mediated dilation: a meta-analysis of randomized clinical trials. Eur. J. Clin. Pharmacol., 2016, 72(4), 385-398.
[http://dx.doi.org/10.1007/s00228-015-1999-4] [PMID: 26690770]
[28]
Liberati, A.; Altman, D.G.; Tetzlaff, J.; Mulrow, C.; Gøtzsche, P.C.; Ioannidis, J.P.; Clarke, M.; Devereaux, P.J.; Kleijnen, J.; Moher, D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med., 2009, 6(7)e1000100
[http://dx.doi.org/10.1371/journal.pmed.1000100] [PMID: 19621070]
[29]
Higgins, J.; Green, S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.3.0; The Cochrane Collaboration, 2011.
[30]
Jadad, A.R.; Moore, R.A.; Carroll, D.; Jenkinson, C.; Reynolds, D.J.M.; Gavaghan, D.J.; McQuay, H.J. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control. Clin. Trials, 1996, 17(1), 1-12.
[http://dx.doi.org/10.1016/0197-2456(95)00134-4] [PMID: 8721797]
[31]
Li, S.; Wu, Y.; Yu, G.; Xia, Q.; Xu, Y. Angiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials. PLoS One, 2014, 9(3)e90217
[http://dx.doi.org/10.1371/journal.pone.0090217] [PMID: 24595033]
[32]
Higgins, J.P.; Thompson, S.G.; Deeks, J.J.; Altman, D.G. Measuring inconsistency in meta-analyses. BMJ, 2003, 327(7414), 557-560.
[http://dx.doi.org/10.1136/bmj.327.7414.557] [PMID: 12958120]
[33]
Anderson, T.J.; Elstein, E.; Haber, H.; Charbonneau, F. Comparative study of ACE-inhibition, angiotensin II antagonism, and calcium channel blockade on flow-mediated vasodilation in patients with coronary disease (BANFF study). J. Am. Coll. Cardiol., 2000, 35(1), 60-66.
[http://dx.doi.org/10.1016/S0735-1097(99)00537-9] [PMID: 10636260]
[34]
Bae, J.H.; Bassenge, E.; Lim, D.M.; Synn, Y.C.; Kim, K.Y.; Schwemmer, M. Effects of lacidipine on vascular responses in patients with coronary artery disease. Int. J. Cardiol., 2005, 101(3), 377-383.
[http://dx.doi.org/10.1016/j.ijcard.2004.03.046] [PMID: 15907404]
[35]
Benndorf, R.A.; Appel, D.; Maas, R.; Schwedhelm, E.; Wenzel, U.O.; Böger, R.H. Telmisartan improves endothelial function in patients with essential hypertension. J. Cardiovasc. Pharmacol., 2007, 50(4), 367-371.
[http://dx.doi.org/10.1097/FJC.0b013e31811dfbe7] [PMID: 18049303]
[36]
Clarkson, P.; Mullen, M.J.; Donald, A.E.; Powe, A.J.; Thomson, H.; Thorne, S.A.; Bull, T.; Deanfield, J.E. The effect of amlodipine on endothelial function in young adults with a strong family history of premature coronary artery disease: a randomised double blind study. Atherosclerosis, 2001, 154(1), 171-177.
[http://dx.doi.org/10.1016/S0021-9150(00)00455-X] [PMID: 11137097]
[37]
Fang, L.; Zheng, F.; Qingyin, T.; Ming, Z.; Yanyan, H. Effect of ramipril on endothelial dysfunction in patients with essential hyperten-sion. Clin. Drug Investig., 2002, 22(7), 449-453.
[http://dx.doi.org/10.2165/00044011-200222070-00005]
[38]
Fujimura, N.; Noma, K.; Hata, T.; Soga, J.; Hidaka, T.; Idei, N.; Fujii, Y.; Mikami, S.; Maruhashi, T.; Iwamoto, Y.; Kihara, Y.; Chayama, K.; Kato, H.; Liao, J.K.; Higashi, Y. ROCK Study Group. Mineralocorticoid receptor blocker eplerenone improves endothelial function and inhibits Rho-associated kinase activity in patients with hypertension. Clin. Pharmacol. Ther., 2012, 91(2), 289-297.
[http://dx.doi.org/10.1038/clpt.2011.227] [PMID: 22205191]
[39]
Ghiadoni, L.; Magagna, A.; Versari, D.; Kardasz, I.; Huang, Y.; Taddei, S.; Salvetti, A. Different effect of antihypertensive drugs on conduit artery endothelial function. Hypertension, 2003, 41(6), 1281-1286.
[http://dx.doi.org/10.1161/01.HYP.0000070956.57418.22] [PMID: 12719441]
[40]
Koh, K.K.; Quon, M.J.; Han, S.H.; Lee, Y.; Kim, S.J.; Koh, Y.; Shin, E.K. Distinct vascular and metabolic effects of different classes of anti-hypertensive drugs. Int. J. Cardiol., 2010, 140(1), 73-81.
[http://dx.doi.org/10.1016/j.ijcard.2008.11.017] [PMID: 19059660]
[41]
Morimoto, S.; Yano, Y.; Maki, K.; Sawada, K. Renal and vascular protective effects of telmisartan in patients with essential hypertension. Hypertens. Res., 2006, 29(8), 567-572.
[http://dx.doi.org/10.1291/hypres.29.567] [PMID: 17137211]
[42]
Muiesan, M.L.; Salvetti, M.; Monteduro, C.; Rizzoni, D.; Zulli, R.; Corbellini, C.; Brun, C.; Agabiti-Rosei, E. Effect of treatment on flow-dependent vasodilation of the brachial artery in essential hypertension. Hypertension, 1999, 33(1 Pt 2), 575-580.
[http://dx.doi.org/10.1161/01.HYP.33.1.575] [PMID: 9931168]
[43]
Muiesan, M.L.; Salvetti, M.; Belotti, E.; Paini, A.; Rosei, C.A.; Aggiusti, C.; Scotti, A.; de Ciuceis, C.; Rizzoni, D.; Rosei, E.A. Effects of barnidipine in comparison with hydrochlorothiazide on endothelial function, as assessed by flow mediated vasodilatation in hypertensive patients. Blood Press., 2011, 20(4), 244-251.
[http://dx.doi.org/10.3109/08037051.2011.561072] [PMID: 21332412]
[44]
Takiguchi, S.; Ayaori, M.; Uto-Kondo, H.; Iizuka, M.; Sasaki, M.; Komatsu, T.; Takase, B.; Adachi, T.; Ohsuzu, F.; Ikewaki, K. Olmesartan improves endothelial function in hypertensive patients: link with extracellular superoxide dismutase. Hypertens. Res., 2011, 34(6), 686-692.
[http://dx.doi.org/10.1038/hr.2011.11] [PMID: 21307868]
[45]
Uehata, A.; Takase, B.; Nishioka, T.; Kitamura, K.; Akima, T.; Kurita, A.; Isojima, K. Effect of quinapril versus nitrendipine on endothelial dysfunction in patients with systemic hypertension. Am. J. Cardiol., 2001, 87(12), 1414-1416.
[http://dx.doi.org/10.1016/S0002-9149(01)01567-3] [PMID: 11397368]
[46]
Wei, D.; He, W.Y.; Lv, Q.Z. Effect of nisoldipine and olmesartan on endothelium-dependent vasodilation in essential hypertensive patients. CNS Neurosci. Ther., 2012, 18(5), 400-405.
[http://dx.doi.org/10.1111/j.1755-5949.2012.00304.x] [PMID: 22533725]
[47]
Yilmaz, M.I.; Carrero, J.J.; Martín-Ventura, J.L.; Sonmez, A.; Saglam, M.; Celik, T.; Yaman, H.; Yenicesu, M.; Eyileten, T.; Moreno, J.A.; Egido, J.; Blanco-Colio, L.M. Combined therapy with renin-angiotensin system and calcium channel blockers in type 2 diabetic hypertensive patients with proteinuria: effects on soluble TWEAK, PTX3, and flow-mediated dilation. Clin. J. Am. Soc. Nephrol., 2010, 5(7), 1174-1181.
[http://dx.doi.org/10.2215/CJN.01110210] [PMID: 20430947]
[48]
Radenković, M. Pioglitazone and endothelial dysfunction: pleiotropic effects and possible therapeutic implications. Sci. Pharm., 2014, 82(4), 709-721.
[http://dx.doi.org/10.3797/scipharm.1407-16] [PMID: 26171320]
[49]
Vanhoutte, P.M.; Shimokawa, H.; Feletou, M.; Tang, E.H.C. Endothelial dysfunction and vascular disease - a 30th anniversary update. Acta Physiol. (Oxf.), 2017, 219(1), 22-96.
[http://dx.doi.org/10.1111/apha.12646] [PMID: 26706498]
[50]
Chung, N.A.; Beevers, D.G.; Lip, G. Effects of losartan versus hydrochlorothiazide on indices of endothelial damage/dysfunction, angiogenesis and tissue factor in essential hypertension. Blood Press., 2004, 13(3), 183-189.
[http://dx.doi.org/10.1080/08037050410033312] [PMID: 15223728]
[51]
Raptis, A.E.; Markakis, K.P.; Mazioti, M.C.; Ikonomidis, I.; Maratou, E.P.; Vlahakos, D.V.; Kotsifaki, E.E.; Voumvourakis, A.N.; Tsirogianni, A.G.; Lambadiari, V.A.; Lekakis, J.P.; Raptis, S.A.; Dimitriadis, G.D. Effect of aliskiren on circulating endothelial progenitor cells and vascular function in patients with type 2 diabetes and essential hypertension. Am. J. Hypertens., 2015, 28(1), 22-29.
[http://dx.doi.org/10.1093/ajh/hpu119] [PMID: 24994608]
[52]
Rubio-Guerra, A.F.; Garro-Almendaro, A.K.; Elizalde-Barrera, C.I.; Suarez-Cuenca, J.A.; Duran-Salgado, M.B. Effect of losartan combined with amlodipine or with a thiazide on uric acid levels in hypertensive patients. Ther. Adv. Cardiovasc. Dis., 2017, 11(2), 57-62.
[http://dx.doi.org/10.1177/1753944716678538] [PMID: 27932570]
[53]
Shahin, Y.; Khan, J.A.; Samuel, N.; Chetter, I. Angiotensin converting enzyme inhibitors effect on endothelial dysfunction: a meta-analysis of randomised controlled trials. Atherosclerosis, 2011, 216(1), 7-16.
[http://dx.doi.org/10.1016/j.atherosclerosis.2011.02.044] [PMID: 21411098]
[54]
Fukutomi, M.; Hoshide, S.; Mizuno, H.; Kario, K. Differential effects of aliskiren/amlodipine combination and high-dose amlodipine monotherapy on endothelial function in elderly hypertensive patients. Am. J. Hypertens., 2014, 27(1), 14-20.
[http://dx.doi.org/10.1093/ajh/hpt158] [PMID: 24008122]
[55]
Celık, T.; Balta, S.; Karaman, M.; Ahmet Ay, S.; Demırkol, S.; Ozturk, C.; Dınc, M.; Unal, H.U.; Yılmaz, M.I.; Kılıc, S.; Kurt, G.; Tas, A.; Iyısoy, A.; Quartı-Trevano, F.; Fıcı, F.; Grassı, G. Endocan, a novel marker of endothelial dysfunction in patients with essential hypertension: comparative effects of amlodipine and valsartan. Blood Press., 2015, 24(1), 55-60.
[http://dx.doi.org/10.3109/08037051.2014.972816] [PMID: 25390761]
[56]
Peller, M.; Ozierański, K.; Balsam, P.; Grabowski, M.; Filipiak, K.J.; Opolski, G. Influence of beta-blockers on endothelial function: A meta-analysis of randomized controlled trials. Cardiol. J., 2015, 22(6), 708-716.
[http://dx.doi.org/10.5603/CJ.a2015.0042] [PMID: 26202651]
[57]
Derosa, G.; Mugellini, A.; Pesce, R.M.; D’Angelo, A.; Maffioli, P. Barnidipine compared to lercanidipine in addition to losartan on endothelial damage and oxidative stress parameters in patients with hypertension and type 2 diabetes mellitus. BMC Cardiovasc. Disord., 2016, 16(1), 66.
[http://dx.doi.org/10.1186/s12872-016-0237-z] [PMID: 27068332]
[58]
Zhou, T.; Huang, X.; Cai, X.; Xie, L. Combined treatment of irbesartan and diltiazem ameliorates endothelium dependent vasodilatation in hypertensives. Clin. Exp. Hypertens., 2017, 39(7), 612-618.
[http://dx.doi.org/10.1080/10641963.2017.1306537] [PMID: 28613098]

Rights & Permissions Print Cite
Article Metrics
30
2
© 2024 Bentham Science Publishers | Privacy Policy