ORIGINAL ARTICLE The effect of candesartan on pentraxin-3 plasma levels as marker of endothelial dysfunction in patients with essential arterial hypertension V. Buda 1 • M. Andor 2 • C. Cristescu 1 • M. Voicu 1 • F. Cochera 2 • P. Tuduce 3 • L. Petrescu 4 • M. C. Tomescu 2 Received: 10 August 2016 / Accepted: 7 February 2017 Ó Royal Academy of Medicine in Ireland 2017 Abstract Background In the last decades, the studies performed on the field of endothelial dysfunction confirmed the fact that the starting point of this pathology is the inflammation. Several inflammatory biomarkers had been discovered and studied, ones showing systemic inflammation, and others being more specific biomarkers and showing the local inflammation. Pentraxin-3 (PTX3) is a new inflammatory biomarker, from the same family as high-selectivity C-re- active protein (hs-CRP), but it is a more specific biomarker, due to its local production: the endothelial cells and not the liver like in the case of hs-CRP. Aims Several antihypertensive classes of drugs seem to have a positive impact on reducing the local endothelial inflammation, beyond their effect of lowering the blood pressure, so this study aims to analyze the effect of can- desartan on the two inflammatory biomarkers: PTX3 and CRP, compared with other antihypertensive drugs, in hypertensive patients with endothelial dysfunction. Methods A total of 365 patients were included in the study: 127 hypertensive patients were under treatment with candesartan, 134 patients were under treatment with other hypotensive medication (beta blockers, calcium channel blockers, and diuretics), both groups with controlled values of blood pressure, and 104 were normotensive persons. Classical methods of assessing the endothelial function were correlated with these biochemical markers. Results The patients treated with candesartan had a sig- nificant lower value of PTX3 and hs-CRP, compared with those under treatment with other antihypertensive medi- cation as follows: PTX3: 0.61 ± 0.49 vs 0.95 ± 1.04 ng/ ml, P = 0.006 and hs-CRP: 0.19 ± 0.20 vs 0.20 ± 0.22 mg/dl, P = 0.54. Conclusions Candesartan decreases PTX3 and hs-CRP plasma levels more powerful than other classes of antihy- pertensive drugs (beta blockers, calcium channel blockers, and diuretics), so we may assume that candesartan has a more potent action in reversing endothelial dysfunction and that it offers a higher vascular protection than other classes of antihypertensive drugs. We are suggesting that this new biochemical marker, PTX3, might be better and more specific marker for endothelial dysfunction, than hs-CRP. Keywords Candesartan Á Pentraxin-3 Á PTX3 Á Endothelial dysfunction Á hs-CRP Á Essential arterial hypertension Introduction The endothelium plays a central role in the pathogenesis of cardiovascular diseases. Endothelial function may be assessed by measuring vasomotor responses or inflamma- tory biomarkers derived from endothelium. Endothelial vasomotor functions measured in the heart and in the & M. Andor andorminodora@gmail.com 1 Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, ‘‘Victor Babes’’ University of Medicine and Pharmacy Timis ¸oara, 2 Eftimie Murgu Street, 300041 Timisoara, Romania 2 Department of Medical Semiotics, Faculty of Medicine, ‘‘Victor Babes’’ University of Medicine and Pharmacy Timis ¸oara, 2 Eftimie Murgu Street, 300041 Timisoara, Romania 3 Department of Balneophysiotherapy, Rheumatology and Rehabilitation, ‘‘Vasile Goldis’’ Western University, 94 Revolutiei Blvd, Arad, Romania 4 Cardiovascular Diseases Institute of Timisoara, 13 Gheorghe Adam Street, Timisoara, Romania 123 Ir J Med Sci DOI 10.1007/s11845-017-1580-5