Derosa Giuseppe, Mugellini Amedeo, Pesce Rosa Maria, D'Angelo Angela, Maffioli Pamela
From the Department of Internal Medicine and Therapeutics, University of Pavia, and Fondazione IRCCS Policlinico San Matteo (GD, AM, RMP, ADA, PM); Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research (GD); Laboratory of Molecular Medicine (GD, ADA); and PhD School in Experimental Medicine (PM), University of Pavia, Pavia, Italy.
Medicine (Baltimore). 2016 Mar;95(13):e3084. doi: 10.1097/MD.0000000000003084.
To evaluate the effects of a fixed combination of olmesartan/amlodipine compared with olmesartan or amlodipine alone on some parameters of endothelial damage in diabetic, hypertensive patients.We enrolled 221 patients; 74 were randomized to olmesartan 20 mg, 72 to amlodipine 10 mg, and 75 to olmesartan/amlodipine fixed combination 20/5 mg for 12 months. We assessed blood pressure monthly; in addition, we also assessed at baseline, and after 6 and 12 months, the following parameters: lipoprotein (a), myeloperoxidase (MPO), isoprostanes, and paraoxonase-1 (PON-1). Blood pressure values obtained with fixed olmesartan/amlodipine combination were significantly lower than those reached with single monotherapies. There was a reduction of lipoprotein (a), and isoprostanes levels with olmesartan/amlodipine fixed combination, both compared with baseline, and with single monotherapies. On the other hand, there was an increase of PON-1 with fixed olmesartan/amlodipine combination, both compared with baseline, and with single drugs. All treatments reduced MPO compared with baseline; however, in group-to-group comparison, MPO reduction was greater with olmesartan/amlodipine fixed combination. Fixed combination of olmesartan/amlodipine was more effective than single monotherapies in reducing oxidative stress, especially in increasing PON-1, and reducing isoprostanes levels in diabetic and hypertensive patients.
为评估奥美沙坦/氨氯地平固定复方与单用奥美沙坦或氨氯地平相比，对糖尿病高血压患者内皮损伤某些参数的影响。我们纳入了221例患者；74例随机分配至奥美沙坦20毫克组，72例至氨氯地平10毫克组，75例至奥美沙坦/氨氯地平20/5毫克固定复方组，治疗12个月。我们每月评估血压；此外，还在基线、6个月和12个月后评估以下参数：脂蛋白（a）、髓过氧化物酶（MPO）、异前列腺素和对氧磷酶-1（PON-1）。奥美沙坦/氨氯地平固定复方获得的血压值显著低于单药治疗组。与基线及单药治疗相比，奥美沙坦/氨氯地平固定复方可降低脂蛋白（a）和异前列腺素水平。另一方面，与基线及单药相比，奥美沙坦/氨氯地平固定复方可使PON-1升高。与基线相比，所有治疗均降低了MPO；然而，组间比较中，奥美沙坦/氨氯地平固定复方降低MPO的幅度更大。奥美沙坦/氨氯地平固定复方在降低氧化应激方面比单药治疗更有效，尤其是在升高PON-1及降低糖尿病高血压患者异前列腺素水平方面。
