Erel İÇEL, Halil İbrahim İMAMOĞLU, Adem TÜRK, Aykut IÇEL, Nurettin AKYOL

A comparison of the effects of perindopril arginine and amlodipine on choroidal thickness in patients with primary hypertension

Background/aim: This study aimed to investigate the effects of two different medical treatment options on choroidal thickness (CT) in patients with primary hypertension. Materials and methods: Forty newly diagnosed primary hypertension patients and 21 healthy volunteers were included. The patients were randomly divided into two subgroups. Group I started on perindopril arginine and Group II started on amlodipine. Submacular CT using optical coherence tomography (OCT) was measured before treatment and at the third and sixth months after treatment. Results: Initial mean arterial pressure (MAP) values in Groups I and II and the control group were 113.4, 109.8, and 89.4 mmHg, respectively, and mean CT values were 257.9, 286.5, and 300.9 μm. Mean MAP values in Groups I and II and the control group at the sixth month after treatment were 99.7, 99.6, and 90.2 mmHg, respectively, and mean CT values were 293.1, 286, and 297.4 μm. Analysis of the changes occurring during the study revealed significant variation in MAP in Groups I and II, and in CT in Group I only. Conclusion: A gradual increase in CT developed with perindopril arginine therapy in patients with primary hypertension, while no significant change occurred in CT in the amlodipine group.

Keywords:

Amlodipine, hypertension, perindopril, choroid, optical coherence tomography,

PDF

___

Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, Prabhakaran D. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens 2014; 32: 1170-1177.
Gupta R, Pandey RM, Misra A, Agrawal A, Misra P, Dey S, Rao S, Menon VU, Kamalamma N, Vasantha Devi KP et al. High prevalence and low awareness, treatment and control of hypertension in Asian Indian women. J Hum Hypertens 2012; 26: 585-593.
Carretero OA, Oparil S. Essential hypertension. Part I: definition and etiology. Circulation 2000; 101: 329-335.
Bhargava M, Ikram MK, Wong TY. How does hypertension affect your eyes? J Hum Hypertens 2012; 26: 71-83.
James PA, Oparil S, Carter BL, Cushman WC, Dennison- Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311: 507-520.
Kramkowski K, Mogielnicki A, Buczko W. The physiological significance of the alternative pathways of angiotensin II production. J Physiol Pharmacol 2006; 57: 529-539.
Brugts JJ, Ferrari R, Simoons ML. Angiotensin-converting enzyme inhibition by perindopril in the treatment of cardiovascular disease. Expert Rev Cardiovasc Ther 2009; 7: 345-360.
Shetty K, Shetty R, Bairy L, Rao P, Kiran A, Shetty M, Deepak, Nayak V. A comparative study on clinical and biochemical parameters in amlodipine and cilnidipine treated hypertensive patients. J Clin Diagn Res 2017; 11: FC01-FC05.
Mrejen S, Spaide RF. Optical coherence tomography: imaging of the choroid and beyond. Surv Ophthalmol 2013; 58: 387-429.
Kur J, Newman EA, Chan-Ling T. Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease. Prog Retin Eye Res 2012; 31: 377- 406.
Nickla DL, Wallman J. The multifunctional choroid. Prog Retin Eye Res 2010; 29: 144-168.
Akyol N, Kalkisim A, Turk A, Kola M, Imamoglu HI. Evaluation of the effects on choroidal thickness of bimatoprost 0.03% versus a brinzolamide 1.0%/timolol maleate 0.5% fixed combination. Cutan Ocul Toxicol 2017; 36: 397-403.
Turk A, Ceylan OM, Arici C, Keskin S, Erdurman C, Durukan AH, Mutlu FM, Altinsoy HI. Evaluation of the nerve fiber layer and macula in the eyes of healthy children using spectral- domain optical coherence tomography. Am J Ophthalmol 2012; 153: 552-559.
Kola M, Kalkisim A, Karkucak M, Turk A, Capkin E, Can I, Serdar OF, Mollamehmetoglu S, Ayar A. Evaluation of choroidal thickness in ankylosing spondylitis using optical coherence tomography. Ocul Immunol Inflamm 2014; 22: 434-438.
Türk A, Kola M, Akyol N, Erdöl H, İmamoğlu Hİ. Optical coherence tomography findings of active ocular toxoplasmosis complicated with serous macular detachment. Turkiye Klinikleri J Med Sci 2010; 30: 1409-1412.
Branchini LA, Adhi M, Regatieri CV, Nandakumar N, Liu JJ, Laver N, Fujimoto JG, Duker JS. Analysis of choroidal morphologic features and vasculature in healthy eyes using spectral-domain optical coherence tomography. Ophthalmology 2013; 120: 1901-1908.
Kim YJ, Kang MH, Cho HY, Lim HW, Seong M. Comparative study of macular ganglion cell complex thickness measured by spectral-domain optical coherence tomography in healthy eyes, eyes with preperimetric glaucoma, and eyes with early glaucoma. Jpn J Ophthalmol 2014; 58: 244-251.
Akay F, Gundogan FC, Yolcu U, Toyran S, Uzun S. Choroidal thickness in systemic arterial hypertension. Eur J Ophthalmol 2016; 26: 152-157.
Branchini L, Regatieri CV, Flores-Moreno I, Baumann B, Fujimoto JG, Duker JS. Reproducibility of choroidal thickness measurements across three spectral domain optical coherence tomography systems. Ophthalmology 2012; 119: 119-123.
Cao J, McLeod S, Merges CA, Lutty GA. Choriocapillaris degeneration and related pathologic changes in human diabetic eyes. Arch Ophthalmol 1998; 116: 589-597.
Schmidt KG, von Rückmann A, Kemkes-Matthes B, Hammes HP. Ocular pulse amplitude in diabetes mellitus. Br J Ophthalmol 2000; 84: 1282-1284.
Adhi M, Lau M, Liang MC, Waheed NK, Duker JS. Analysis of the thickness and vascular layers of the choroid in eyes with geographic atrophy using spectral-domain optical coherence tomography. Retina 2014; 34: 306-312.
McCourt EA, Cadena BC, Barnett CJ, Ciardella AP, Mandava N, Kahook MY. Measurement of subfoveal choroidal thickness using spectral domain optical coherence tomography. Ophthalmic Surg Lasers Imaging 2010; 41 (Suppl.): S28-S33.
Chang L, Pan CW, Ohno-Matsui K, Lin X, Cheung GC, Gazzard G, Koh V, Hamzah H, Tai ES, Lim SC et al. Myopia- related fundus changes in Singapore adults with high myopia. Am J Ophthalmol 2013; 155: 991-999.
Ma L, Tang SM, Rong SS, Chen H, Young AL, Kumaramanickavel G, Pang CP, Chen LJ. Association of PEDF polymorphisms with age-related macular degeneration and polypoidal choroidal vasculopathy: a systematic review and meta-analysis. Sci Rep 2015; 5: 9497.
Al-Rashaed S, Arevalo JF. Long-term follow-up of choroidal neovascularization secondary to angioid streaks: case series and literature review. Clin Ophthalmol 2012; 6: 1029-1034.
Matsuoka M, Ogata N, Otsuji T, Nishimura T, Takahashi K, Matsumura M. Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy. Br J Ophthalmol 2004; 88: 809-815.
Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N, Jaisser F, Behar-Cohen F. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res 2015; 48: 82-118.
Maruko I, Iida T, Sugano Y, Oyamada H, Sekiryu T, Fujiwara T, Spaide RF. Subfoveal choroidal thickness after treatment of Vogt-Koyanagi-Harada disease. Retina 2011; 31: 510-517.
Zannad F, Bernaud CM, Fay R. Double-blind, randomized, multicentre comparison of the effects of amlodipine and perindopril on 24 h therapeutic coverage and beyond in patients with mild to moderate hypertension. General Physicians Investigators’ Group. J Hypertens 1999; 17: 137-146.
Schmetterer L, Findl O, Strenn K, Jilma B, Graselli U, Eichler HG, Wolzt M. Effects of endothelin-1 (ET-1) on ocular hemodynamics. Curr Eye Res 1997; 16: 687-692.
Stokely ME, Yorio T, King MA. Endothelin-1 modulates anterograde fast axonal transport in the central nervous system. J Neurosci Res 2005; 79: 598-607.
Strenn K, Matulla B, Wolzt M, Findl O, Bekes MC, Lamsfuss U, Graselli U, Rainer G, Menapace R, Eichler HG et al. Reversal of endothelin-1-induced ocular hemodynamic effects by low- dose nifedipine in humans. Clin Pharmacol Ther 1998; 63: 54- 63.
Meyer P, Lang MG, Flammer J, Lüscher TF. Effects of calcium channel blockers on the response to endothelin-1, bradykinin and sodium nitroprusside in porcine ciliary arteries. Exp Eye Res 1995; 60: 505-510.
Lang MG, Zhu P, Meyer P, Noll G, Haefliger IO, Flammer J, Lüscher TF. Amlodipine and benazeprilat differently affect the responses to endothelin-1 and bradykinin in porcine ciliary arteries: effects of a low and high dose combination. Curr Eye Res 1997; 16: 208-213.
Cullinane AB, Leung PS, Ortego J, Coca-Prados M, Harvey BJ. Renin-angiotensin system expression and secretory function in cultured human ciliary body non-pigmented epithelium. Br J Ophthalmol 2002; 86: 676-683.
Zengin MÖ, Karahan E, Özyurtlu F, Tuncer İ, Pekel N, Çınar E, Küçükerdönmez C. The effect of blood pressure regulation on choroidal thickness. Journal of Retina-Vitreous 2014; 22: 213- 216 (in Turkish with abstract in English).
Ganekal S, Dorairaj S, Jhanji V, Kudlu K. Effect of topical calcium channel blockers on intraocular pressure in steroid- induced glaucoma. J Curr Glaucoma Pract 2014; 8: 15-19.
Mito T, Delamere NA, Coca-Prados M. Calcium-dependent regulation of cation transport in cultured human nonpigmented ciliary epithelial cells. Am J Physiol 1993; 264: C519-C526.
Abelson MB, Gilbert CM, Smith LM. Sustained reduction of intraocular pressure in humans with the calcium channel blocker verapamil. Am J Ophthalmol 1988; 105: 155-159.
Beatty JF, Krupin T, Nichols PF, Becker B. Elevation of intraocular pressure by calcium channel blockers. Arch Ophthalmol 1984; 102: 1072-1076.
Payne LJ, Slagle TM, Cheeks LT, Green K. Effect of calcium channel blockers on intraocular pressure. Ophthalmic Res 1990; 22: 337-341.
Kelly SP, Walley TJ. Effect of the calcium antagonist nifedipine on intraocular pressure in normal subjects. Br J Ophthalmol 1988; 72: 216-218.
Lotti VJ, Pawlowski N. Prostaglandins mediate the ocular hypotensive action of the angiotensin converting enzyme inhibitor MK-422 (enalaprilat) in African green monkeys. J Ocul Pharmacol 1990; 6: 1-7.
Al-Sereiti MR, Turner P. Effect of captopril (an angiotensin- converting enzyme inhibitor) on intraocular pressure in healthy human volunteers. J Ocul Pharmacol 1989; 5: 1-5.
Çalişkan S, Uğurbaş SC, Alpay A, Uğurbaş SH. Changes in the choroidal thickness and axial length upon mannitol infusion in patients with asymmetric intraocular pressure. J Glaucoma 2016; 25: 891-895.