Nomura S, Inami N, Kimura Y, Omoto S, Shouzu A, Nishikawa M, Iwasaka T
Division of Hematology, Kishiwada City Hospital, Osaka, Japan.
J Hum Hypertens. 2007 Jan;21(1):38-44. doi: 10.1038/sj.jhh.1002100. Epub 2006 Oct 19.
Nifedipine, a dihydropyridine calcium antagonist, improves endothelial function in patients with hypercholesterolaemia by enhancing nitric oxide (NO) activity, and increases endothelial NO bioavailability by antioxidant mechanisms. We administered a long-acting nifedipine formulation (controlled release (CR) nifedipine: 20 mg/day) to hypertensive patients for 6 months. There were no other changes of drug treatment during therapy with CR nifedipine. Clinical and biochemical data obtained before and after CR nifedipine administration were compared. All markers were measured by enzyme-linked immunosorbant assay. The levels of soluble markers (soluble CD40 ligand, soluble P-selectin, and soluble E-selectin), microparticles (MP) (platelet-derived MP, monocyte-derived MP, and endothelial cell-derived MP), and adiponectin differed between the control group and the hypertension group. The levels of these markers were also different in hypertensive patients with and without type 2 diabetes compared with the control group. In the hypertensive patients with type 2 diabetes, all markers except adiponectin decreased significantly after 3 months of CR nifedipine treatment. In contrast, markers were unchanged in the hypertensive patients without type 2 diabetes. Adiponectin was increased after 6 months of CR nifedipine treatment in hypertensive patients with type 2 diabetes. The effects of CR nifedipine on platelet/monocyte activation and adiponectin levels demonstrated in the present study indicate the potential effectiveness of calcium antagonist therapy for hypertensive patients with type 2 diabetes.
硝苯地平是一种二氢吡啶类钙拮抗剂,通过增强一氧化氮(NO)活性改善高胆固醇血症患者的内皮功能,并通过抗氧化机制增加内皮NO生物利用度。我们给予高血压患者长效硝苯地平制剂(控释(CR)硝苯地平:20毫克/天),持续6个月。在CR硝苯地平治疗期间,药物治疗无其他变化。比较CR硝苯地平给药前后获得的临床和生化数据。所有标志物均通过酶联免疫吸附测定法测量。对照组和高血压组之间的可溶性标志物(可溶性CD40配体、可溶性P选择素和可溶性E选择素)、微粒(MP)(血小板衍生MP、单核细胞衍生MP和内皮细胞衍生MP)以及脂联素水平存在差异。与对照组相比,有和没有2型糖尿病的高血压患者这些标志物的水平也不同。在患有2型糖尿病的高血压患者中,CR硝苯地平治疗3个月后,除脂联素外的所有标志物均显著下降。相比之下,没有2型糖尿病的高血压患者标志物无变化。在患有2型糖尿病的高血压患者中,CR硝苯地平治疗6个月后脂联素增加。本研究中显示的CR硝苯地平对血小板/单核细胞活化和脂联素水平的影响表明钙拮抗剂治疗对患有2型糖尿病的高血压患者具有潜在疗效。