5. THE EFFECT OF CILOSTAZOL TO ARTERIAL STIFFNESS IN THE HYPERTENSIVE PATIENT

Abstract

Background: Cilostazol is a potent antiplatelet agent that selectively inhibits phosphodiesterase III, and also it has beneficial effect to peripheral arterial disease, like intermittent claudication, by direct vasodilative action. But the effect of cilostazol on arterial stiffness is unclear. We investigated the effect of cilostazol on arterial stiffness by using Pulse Wave Velocity (PWV) which is most common and non-invasive measure technique. Methods: From May, 2006, Total 708 hypertension patients were examined PWV study. 86 patients were taking cilostazol at least 3 month ago before PWV study. The rest 622 patients did not take cilostazol. All value of each aortic PWV, arm PWV, leg PWV of all patients were measured by using pp-1000 and analysed. Results: In cilostazol group, mean period of taking medicine is 823 days (130∼1390days). In baseline characteristics, cilostazol group is older than control group (63.3 vs 56.9 p<0.001), have higher proportion of DM (41.9% vs 32.5% p<0.001), and more frequently taking aspirin and lipid-lowering agent (50.0% vs 33.4% p=0.004, 52.3% vs 32.5% p<0.001 respectively). There is no difference between two groups in aortic PWV and arm PWV (7.73 vs 7.61 m/sec p=0.475, 8.06 vs 8.32 m/sec p=0.092 respectively). But, there is statistically significant difference in leg PWV (9.73 vs 10.12 m/sec, p=0.029). Also, cilostazol use is the independent variable of leg PWV by multiple regression analysis (β=-0.075 p=0.047). Conclusion: In hypertensive patients, the use of cilostazol did not affect aortic PWV and arm PWV. But, leg PWV value was improved significantly. We conclude that cilostazol is more effective on lower extremity arterial stiffness than central arterial stiffness. Further study will need whether effect of cilostazol on peripheral artery disease have related to these improvement of arterial stiffness of lower extremity.