-Short Communication-

Effects of Candesartan Cilexetil Compared with Amlodipine on Serum Asymmetric Dimethylarginine Levels in the Chronic Stage of Cerebral Infarction: A Preliminary Study

Eiko Sunami^1-3, Koichi Nomura^1,2, Yutaka Nishiyama^1,2 and Yasuo Katayama^2,4

¹Department of Neurology, Shioda Hospital, Chiba, Japan
²Department of Internal Medicine, Division of Neurology, Nippon Medical School, Tokyo, Japan
³Department of Rehabilitation Medicine, Nippon Medical School, Tokyo, Japan
⁴Department of Neurology, Tokyo General Hospital, Tokyo, Japan

Objective: Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide synthase inhibitor and a marker of vascular endothelial damage. Angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker (ARB) are reported to reduce the serum ADMA level. Our group administered either ARB or calcium antagonist to patients after cerebral infarction and discussed the ADMA changes observed.
Methods: Hypertensives in the chronic stage of cerebral infarction were enrolled. These subjects included patients of atherothrombotic cerebral infarction or lacunar infarction. The patients received candesartan cilexetil (candesartan group) or amlodipine (amlodipine group). The blood pressure and serum ADMA concentration were measured and compared before the treatment commenced and at 1-3 months after the treatment commenced.
Results: Seven subjects received candesartan and six received amlodipine. There was no difference between the groups in the change of blood pressure before and after the drug treatment. The ADMA level (nmol/mL) fell significantly from 0.57±0.10 (before administration) to 0.52±0.09 (after administration) in the candesartan group (P<0.05). The ADMA level did not change between before and after administration in the amlodipine group.
Conclusion: Treatment with candesartan cilexetil reduced the level of ADMA in hypertensive patients in the chronic stage of cerebral infarction. Candesartan cilexetil may be useful in hypertensive patients at the chronic stage of cerebral infarction with expected anti-atherosclerotic effect.

J Nippon Med Sch 2016; 83: 272-276

Keywords
asymmetric dimethylarginine, cerebral infarction, hypertension, candesartan cilexetil, angiotensin II receptor blocker

Correspondence to
Eiko Sunami, Department of Rehabilitation Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
s2047@nms.ac.jp

Received, December 21, 2015
Accepted, April 14, 2016