Effects of Cilnidipine, an L/N-Type Calcium Channel Blocker, on Carotid Atherosclerosis in Japanese Post-Stroke Hypertensive Patients: Results from the CA-ATTEND Study

Nezu, Tomohisa; Hosomi, Naohisa; Aoki, Shiro; Suzuki, Noriyuki; Teshima, Tsukasa; Sugii, Hitoshi; Nagahama, Shinobu; Kurose, Yoshiki; Makino, Hírofumi; Matsumoto, Masayasu

doi:10.5551/jat.42101

Cited by 10 publications

(11 citation statements)

References 50 publications

(47 reference statements)

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“…Carotid IMT was also considered as a surrogate clinical endpoint for several clinical trials using lipid-lowering, antihypertensive, and/or antidiabetic drugs 34 – 43 ) . A systematic review and meta-analysis showed that low density lipoprotein cholesterol reduction by a statin treatment and carotid IMT change reduction strongly correlated 44 ) .…”

Section: Carotid Imtmentioning

confidence: 99%

“…However, few studies exist on whether carotid IAD is more suitable screening point than carotid IMT for risk stratification of future cerebral or cardiovascular events. Carotid IAD might be decreased by several medications such as antihypertensive agents 43 ) . Although it also may be considered as a surrogate clinical endpoint using several medical intervention, few investigations to assess those associations exist.…”

Section: Other Aspects Of Assessments Using Carotid Ultrasonographmentioning

confidence: 99%

“…Considering the maximum carotid IMT or carotid plaque is essential for the prediction of cerebral and cardiovascular disease. Carotid IMT was also considered as a surrogate clinical endpoint for several clinical trials using lipidlowering, antihypertensive, and/or antidiabetic drugs [34][35][36][37][38][39][40][41][42][43] . A systematic review and meta-analysis showed that low density lipoprotein cholesterol reduction by a statin treatment and carotid IMT change reduction strongly correlated 44) .…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of Carotid Ultrasonography for Risk Stratification of Cerebral and Cardiovascular Disease

Nezu

Hosomi

2020

JAT

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Carotid ultrasonography is useful for the assessments of the risk stratification for stroke or coronary artery disease, because it is a simple, repeatable, and noninvasive procedure. The carotid intima-media thickness (IMT), which is assessed using carotid ultrasonography, is a widely used surrogate marker for the severity of atherosclerosis. Several large clinical studies showed that increased carotid IMT is associated with the future stroke or cardiovascular events. In addition, in many clinical trials, it has been adopted for surrogate markers of clinical endpoints of medical intervention. Moreover, carotid ultrasonography allows the measurement of the presence and characteristics of plaques and the severity of carotid artery stenosis. The unstable morphology of plaque, such as hypoechoic, ulcer, and mobility, is associated with future ischemic stroke events. The screening tool of asymptomatic carotid artery stenosis is also important, although whether routine carotid ultrasonography assessment is recommended in the general population remains controversial. The screening of carotid artery stenosis using ultrasonography is essential for not only daily clinical settings but also management of patients with acute ischemic stroke. The patients with atherothrombotic stroke with severe internal carotid artery stenosis should be considered to surgical intervention, and duplex ultrasound approach is important to estimate for the severity of carotid stenosis. Physicians should keep in mind the usefulness of carotid ultrasonography for risk stratification of cerebral and cardiovascular disease based on various aspects. In addition, visual assessment or dynamic changes using carotid ultrasonography could provide the various and valuable insights in clinical settings.

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Section: Carotid Imtmentioning

confidence: 99%

Section: Other Aspects Of Assessments Using Carotid Ultrasonographmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Usefulness of Carotid Ultrasonography for Risk Stratification of Cerebral and Cardiovascular Disease

Nezu

Hosomi

2020

JAT

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“…Furthermore, great care was taken to select the same level of the common carotid artery at baseline and at follow-up. Fourth, considering that several clinical studies have reported anti-atherosclerotic effects of ACE inhibitors, ARB, or CCB 33 , 34 ) , these medications should be considered as an adjusting covariate. Although chronic use of ACE inhibitors, ARB, or CCB without changes in the doses in our study could imply that their effects on carotid artery elasticity parameters might be less pronounced than new use or dosage change of these medications just before or during the study, their influence on carotid artery elasticity cannot be completely ruled out.…”

Section: Discussionmentioning

confidence: 99%

Assessing Impact of High-Dose Pitavastatin on Carotid Artery Elasticity with Speckle-Tracking Strain Imaging

Kim

Wang

Park

et al. 2018

JAT

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Aim: Speckle-tracking imaging has been introduced for the precise assessment of vessel mechanics. However, there are no data on the role of this imaging tool in assessing the changes in vasculature with statin therapy, which is known to enhance vascular elasticity.Methods: This study was a prospective study including 48 statin-naïve patients (age, 58.2 ± 8.4 years; 29.2% male) with hypercholesterolemia. Circumferential carotid artery strain (CAS) and stiffness index (β2) were measured using speckle-tracking imaging before and after 3 months of high-dose pitavastatin treatment (4 mg daily). For the comparison, we measured conventional carotid elasticity parameters and intima–media thickness using B-mode ultrasound at the same time points.Results: Compared with baseline, there was significant improvement in circumferential CAS (2.98% ± 1.18% to 3.40% ± 1.43%, p = 0.008) and β2 (0.19 ± 0.07 to 0.17 ± 0.08, p = 0.047) after statin therapy. Contrariwise, there were no significant changes in all conventional carotid elasticity metrics and intima–media thickness. When stratifying patients into two subgroups by 10 year atherosclerotic cardiovascular disease (ASCVD) risk, speckle-tracking-derived circumferential CAS and β2 improved significantly only in patients with ASCVD risk ≥ 7.5%.Conclusions: Short-term treatment with high-dose pitavastatin improved carotid artery elasticity measured by speckle-tracking method, but not conventional parameters by B-mode ultrasound. Speckle-tracking-based measurements may allow the early noninvasive assessment of statin effects on vascular function in hypercholesterolemic patients.Abbreviations: CAS: carotid artery strain, β1: classic stiffness index, β2: speckle-tracking-derived stiffness index, IMT: intima-media thickness, ASCVD: atherosclerotic cardiovascular disease, CHD: coronary heart disease, LCL-C: low-density lipoprotein cholesterol, HDL-C: high-density lipoprotein cholesterol, CCA: common carotid artery

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“…Many randomized clinical trials evaluated the effect of anti-hypertensive therapy on C-IMTp. Favorable effects were obtained with either diuretics [113], β-blockers [114][115][116][117], ACE inhibitors [44,118,119], angiotensin II receptor antagonists [116], calcium channel blockers [113][114][115]118,120] or α1 receptor -selective blockers [121]. Only a few studies with ACE inhibitors failed to detect significant effects.…”

Section: Control Of Hypertension and C-imtpmentioning

confidence: 99%

Traditional Risk Factors are Causally Related to Carotid Intima-Media Thickness Progression: Inferences from Observational Cohort Studies and Interventional Trials

Frigerio

Werba

Amato

et al. 2020

CPD

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In the present review, associations between traditional vascular risk factors (VRFs) and carotid intimamedial thickness progression (C-IMTp) as well as the effects of therapies for VRFs control on C-IMTp were appraised to infer causality between each VRF and C-IMTp. Cohort studies indicate that smoking, binge drinking, fatness, diabetes, hypertension and hypercholesterolemia are associated with accelerated C-IMTp. An exception is physical activity, with mixed data. Interventions for the control of obesity, diabetes, hypertension and hypercholesterolemia decelerate C-IMTp. Conversely, scarce information is available regarding the effect of smoking cessation, stop of excessive alcohol intake and management of the metabolic syndrome. Altogether, these data support a causative role of several traditional VRFs on C-IMTp. Shortcomings in study design and/or ultrasonographic protocols may account for most negative studies, which underlines the importance of careful consideration of methodological aspects in investigations using C-IMTp as the outcome.

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Effects of Cilnidipine, an L/N-Type Calcium Channel Blocker, on Carotid Atherosclerosis in Japanese Post-Stroke Hypertensive Patients: Results from the CA-ATTEND Study

Cited by 10 publications

References 50 publications

Usefulness of Carotid Ultrasonography for Risk Stratification of Cerebral and Cardiovascular Disease

Usefulness of Carotid Ultrasonography for Risk Stratification of Cerebral and Cardiovascular Disease

Assessing Impact of High-Dose Pitavastatin on Carotid Artery Elasticity with Speckle-Tracking Strain Imaging

Traditional Risk Factors are Causally Related to Carotid Intima-Media Thickness Progression: Inferences from Observational Cohort Studies and Interventional Trials

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