The effects of angiotensin receptor blockers vs. calcium channel blockers on the acute exercise-induced inflammatory and thrombotic response

Hypertension Research, 09/19/2012

Liakos CI et al. – Angiotensin receptor blockers (ARBs) are most likely more effective than calcium channel blockers (CCBs) at suppressing the exercise–induced acute phase response. Potential protection against exercise–related coronary events remains to be elucidated.


  • A total of 60 never–treated hypertensive patients were randomized to an angiotensin receptor blocker (ARB)– or non–dihydropyridine calcium channel blocker (CCB)–based regimen.
  • Patients with inflammatory or coronary artery disease were excluded.


  • Six months after pharmaceutical BP normalization, the patients underwent a maximal treadmill exercise testing.
  • High–sensitivity C–reactive protein (hsCRP), serum amyloid A (SAA), white blood cells (WBC), tumor necrosis factor–α (TNF–α), interleukin–6 (IL–6), total fibrinogen (TF) and von Willebrand factor (vWF) levels, as well as plasminogen activator inhibitor–1 (PAI–1) activity were measured in blood samples taken while the patients were at rest and during peak exercise.
  • All of these biomarkers increased with exercise, except PAI–1, which decreased (P<0.05 for the difference between resting and peak exercise for all biomarkers).
  • The ARB group had less marked (P<0.05) exercise–induced changes than the CCB group in hsCRP (5.8% vs. 7.7%), SAA (4.2% vs. 7.2%), WBC (46.8% vs. 52.6%), TNF–α (16.3% vs. 24.3%), TF (9.5% vs. 16.9%) and PAI–1 (–9.5% vs. –12.3%) but a similar (P=NS) change in IL–6 (39.4% vs. 38.6%) and vWF (29.2% vs. 28.6%).

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