Endothelial dysfunction is a target for combination antihypertensive therapy in hypertensive patients with type 2 diabetes mellitus

• Published in: Terapevtic̆eskii arhiv Vol. 85; no. 9; pp. 63 - 68
• Main Authors: Statsenko, M E, Derevianchenko, M V, Ostrovskiĭ, O V, Titarenko, M N, Shvets, M K, Bondarev, A M
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) "Consilium Medicum" Publishing house 01.01.2013
• Subjects: Adult; Aged; Amlodipine - administration & dosage; Amlodipine - pharmacology; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - pharmacology; combination antihypertensive therapy; Comorbidity; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Drug Combinations; endothelial dysfunction; Endothelium, Vascular - drug effects; Endothelium, Vascular - physiopathology; Female; Humans; hypertension; Hypertension - drug therapy; Hypertension - epidemiology; Lisinopril - administration & dosage; Lisinopril - pharmacology; Male; Middle Aged; Severity of Illness Index; Time Factors; Treatment Outcome; type 2 diabetes mellitus
• ISSN: 0040-3660; 2309-5342

To evaluate the impact of combination antihypertensive therapy with lisinopril + amlodipine (Ekvator) on endothelial dysfunction in patients with hypertension and concurrent type 2 diabetes mellitus (T2DM). The trial enrolled 30 patients aged 40 to 65 years with Stages II-Ill hypertension concurrent with T2DM. All the patients received combination antihypertensive therapy with lisinopril + amlodipine (ekvator) for 12 weeks. Endothelial function was studied from serum and urinary NO and endothelin-1 concentrations and occlusion test results. 24-hour blood pressure (BP) monitoring and echocardiography were performed; arterial elastic properties and renal function were investigated. After 12-week therapy, 93.3% of the patients achieved BP goals. Endothelial function was improved in hypertensive patients with T2DM: there were increases in both serum and urinary NO production (by 53.5 and 57.1%, respectively) and decreases in serum and urinary endothelin-1 secretion (by 27.7 and 69.6%, respectively). The number of patients with normal microcirculation increased from 13.3 to 73.3% (p < 0.001). There was significant improvement in 24-hour AP monitoring readings and reductions in the left ventricular mass index by 10.7% and microalbuminuria by 27.7%; the number of patients with increased pulse wave velocity along the elastic arteries declined by 30%. Twelve-week treatment with the combined antihypertensive medication ekvator is highly effective and safe for recovering endothelial function and improving the state of target organs in hypertensive patients with T2DM.