Phosphodiesterase type 5 inhibition improves arterial stiffness after exercise but not exercise capacity in hypertensive men
| Autor: | Simon Maxwell, David J. Webb, Lorenzo Malatino, Teresa M. Attina, Iain D. Drummond |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty hypertension excercise capacity Phosphodiesterase type 5 inhibition Sildenafil Blood Pressure Pulse Wave Analysis Piperazines Sildenafil Citrate chemistry.chemical_compound Oxygen Consumption Vascular Stiffness Internal medicine Internal Medicine medicine Humans Sulfones Pulse wave velocity Exercise Exercise Tolerance business.industry VO2 max Hydralazine Middle Aged Phosphodiesterase 5 Inhibitors medicine.disease Pulmonary hypertension Endocrinology Blood pressure chemistry Purines Heart failure Hypertension Arterial stiffness business medicine.drug |
| Zdroj: | American journal of hypertension. 26(3) |
| ISSN: | 1941-7225 |
| Popis: | BACKGROUND: Established hypertension is associated with abnormal exercise hemodynamics and reduced exercise capacity through mechanisms that may include contributions from arterial stiffness and endothelial vasomotor dysfunction. Phosphodiesterase type 5 (PDE5) inhibitors prolong nitric oxide-mediated cyclic guanosine monophosphate (cGMP) signaling in vascular smooth muscle, and have beneficial effects on exercise tolerance in pulmonary hypertension and heart failure. Recent studies suggest they may also be useful antihypertensive agents. We hypothesized they would reduce arterial stiffness and increase exercise capacity in hypertensive men. METHODS: In a 3-way, randomized, placebo-controlled study, 15 untreated hypertensive and 15 matched normotensive male subjects received 50mg sildenafil (PDE5 inhibitor), 25mg hydralazine (control, cGMP-independent vasodilator) or placebo, 3 times daily for 1 week, and the effects on exercise blood pressure (during modest and maximal exercise), peak oxygen uptake, and arterial stiffness were investigated. RESULTS: Peak oxygen uptake was significantly lower in hypertensive than normotensive subjects (analysis of variance [ANOVA] P < 0.0001), but not affected by sildenafil in either group. However, while pulse wave velocity, as a measure of arterial stiffness, increased after exercise in hypertensive men following placebo, sildenafil reversed these changes, significantly reducing pulse wave velocity compared with both placebo and hydralazine (ANOVA P = 0.0001). CONCLUSIONS: PDE5 inhibition with sildenafil did not improve exercise capacity in hypertensive men. Nevertheless, our findings suggest that sildenafil may reduce arterial stiffness in the recovery period after exercise. |
| Databáze: | OpenAIRE |
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