Emory University School of Medicine, Division of Cardiology, Atlanta, GA, USA.
J Cardiovasc Pharmacol Ther. 2012 Jun;17(2):139-45. doi: 10.1177/1074248411413282. Epub 2011 Jul 12.
We sought to determine whether a combination of angiotensin-converting enzyme inhibitors (ACEIs) and the nutraceutical α-lipoic acid (ALA) regulates blood pressure, endothelial function, and proteinuria in diabetic patients with Stage I hypertension.
A total of 40 diabetic patients with Stage I hypertension were treated in a crossover double-blinded manner. Patients were administered quinapril ([QUI] 40 mg/d) for 8 weeks or QUI + ALA (600 mg/d) for 8 weeks. Measurements included blood pressure, 24-hour collection of urinary albumin, and endothelial-dependent flow-mediated dilation (FMD).
There was a change of metabolic parameters in both study groups after 8 weeks of therapy. In comparison to baseline, the 24-hour urinary albumin significantly decreased by 30% in the QUI group (P = .018, time comparison) and 53% in QUI + ALA group (P < .005, time and group comparison). Also, when compared with baseline, FMD significantly increased by 58% in QUI group (P < .005, time comparison) and by 116% in QUI + ALA group (P < .005, time and group comparison). Systolic and diastolic blood pressure reduced significantly by 10% with QUI treatment. There was no further blood pressure reduction when patients were administered both QUI and ALA.
In diabetic patients with hypertension, QUI reduces blood pressure, proteinuria, and improves endothelial function. Moreover, this effect is strongly potentiated with a combination of QUI and ALA. These results may attenuate the progression of vascular pathophysiology seen in patients with a combination of diabetes and hypertension.
我们旨在确定血管紧张素转换酶抑制剂（ACEIs）和营养补充剂α-硫辛酸（ALA）的联合应用是否可以调节 I 期高血压糖尿病患者的血压、内皮功能和蛋白尿。
40 例 I 期高血压糖尿病患者采用交叉双盲方式进行治疗。患者接受 quinapril（[QUI]40mg/d）治疗 8 周或 QUI+ALA（600mg/d）治疗 8 周。测量包括血压、24 小时尿白蛋白收集和内皮依赖性血流介导的扩张（FMD）。
两组患者在 8 周治疗后均发生代谢参数变化。与基线相比，QUI 组 24 小时尿白蛋白显著降低 30%（P=0.018，时间比较），QUI+ALA 组降低 53%（P<0.005，时间和组比较）。此外，与基线相比，QUI 组 FMD 显著增加 58%（P<0.005，时间比较），QUI+ALA 组增加 116%（P<0.005，时间和组比较）。QUI 治疗可使收缩压和舒张压显著降低 10%。当患者同时接受 QUI 和 ALA 治疗时，血压没有进一步降低。
在高血压糖尿病患者中，QUI 可降低血压、蛋白尿并改善内皮功能。此外，QUI 和 ALA 的联合应用可显著增强这种作用。这些结果可能减轻糖尿病和高血压合并患者血管病理生理学进展。
