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在高血压合并2型糖尿病患者中,对比巴尼地平与乐卡地平联合氯沙坦对内皮损伤和氧化应激参数的影响。

Barnidipine compared to lercanidipine in addition to losartan on endothelial damage and oxidative stress parameters in patients with hypertension and type 2 diabetes mellitus.

作者信息

Derosa Giuseppe, Mugellini Amedeo, Pesce Rosa Maria, D'Angelo Angela, Maffioli Pamela

机构信息

Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, P.le C. Golgi, 2, 27100, Pavia, Italy.

Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research, University of Pavia, Pavia, Italy.

出版信息

BMC Cardiovasc Disord. 2016 Apr 12;16:66. doi: 10.1186/s12872-016-0237-z.

Abstract

BACKGROUND

Essential hypertension has been extensively reported to cause endothelial dysfunction. The aim of this study was to evaluate the effects of barnidipine or lercanidipine, in addition to losartan, on some parameters indicative of endothelial damage and oxidative stress in hypertensive, type 2 diabetic patients.

METHODS

One hundred and fifty one patients were randomised to barnidipine, 20 mg/day, or lercanidipine, 20 mg/day, both in addition to losartan, 100 mg/day, for 6 months. We assessed BP every month, in addition, patients underwent ambulatory blood pressure monitoring (ABPM). We also assessed: fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), some markers such as high-sensitivity C-reactive protein (Hs-CRP), tumor necrosis factor-α (TNF-α), metalloproteinase-2 (MMP-2) and -9 (MMP-9), soluble vascular adhesion protein-1 (sVCAM-1), soluble intercellular adhesion protein-1 (sICAM-1), isoprostanes and paraoxonase-1 (PON-1).

RESULTS

Both barnidipine and lercanidipine resulted in a significant reduction in blood pressure, even if the reduction obtained with barnidipine + losartan was greater than that obtained with lercanidipine + losartan. Data recorded with ABPM also showed a similar trend. Barnidipine + losartan reduced the levels of Hs-CRP, TNF-α, sVCAM-1, sICAM-1, and isoprostanes both compared to baseline and to lercanidipine + losartan.

CONCLUSIONS

Barnidipine + losartan gave an improvement of some parameters indicative of endothelial damage and oxidative stress in diabetic and hypertensive patients.

TRIAL REGISTRATION

NCT02064218 , ClinicalTrials.gov.

摘要

背景

大量报道指出,原发性高血压会导致内皮功能障碍。本研究旨在评估在氯沙坦基础上加用巴尼地平或乐卡地平对2型糖尿病高血压患者内皮损伤和氧化应激相关指标的影响。

方法

151例患者被随机分为两组,一组每日服用20 mg巴尼地平,另一组每日服用20 mg乐卡地平,两组均联合每日服用100 mg氯沙坦,疗程6个月。我们每月测量血压,此外,患者还接受动态血压监测(ABPM)。我们还评估了:空腹血糖(FPG)、糖化血红蛋白(HbA1c)、一些标志物,如高敏C反应蛋白(Hs-CRP)、肿瘤坏死因子-α(TNF-α)、金属蛋白酶-2(MMP-2)和-9(MMP-9)、可溶性血管细胞黏附分子-1(sVCAM-1)、可溶性细胞间黏附分子-1(sICAM-1)、异前列腺素和对氧磷酶-1(PON-1)。

结果

巴尼地平和乐卡地平均可显著降低血压,尽管巴尼地平+氯沙坦组的降压效果大于乐卡地平+氯沙坦组。ABPM记录的数据也显示出类似趋势。与基线水平以及乐卡地平+氯沙坦组相比,巴尼地平+氯沙坦组降低了Hs-CRP、TNF-α、sVCAM-1、sICAM-1和异前列腺素的水平。

结论

巴尼地平+氯沙坦可改善糖尿病高血压患者内皮损伤和氧化应激的一些指标。

试验注册

NCT02064218,ClinicalTrials.gov。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c248/4828780/98f8d6edbaa0/12872_2016_237_Fig1_HTML.jpg

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