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Functional vascular study in hypertensive subjects with type 2 diabetes using losartan or amlodipine.

Pozzobon CR, Gismondi RA, Bedirian R, Ladeira MC, Neves MF, Oigman W - Arq. Bras. Cardiol. (2014)

Bottom Line: The mean age of the patients in both groups was similar (amlodipine group: 54.9 ± 4.5 years; losartan group: 54.0 ± 6.9 years), with no significant difference in the mean BP [amlodipine group: 145 ± 14 mmHg (systolic) and 84 ± 8 mmHg (diastolic); losartan group: 153 ± 19 mmHg (systolic) and 90 ± 9 mmHg (diastolic)].The augmentation index (30% ± 9% and 36% ± 8%, p = 0.025) and augmentation pressure (16 ± 6 mmHg and 20 ± 8 mmHg, p = 0.045) were lower in the amlodipine group when compared with the losartan group.However, the use of losartan may be associated with independent vascular reactivity to the pressor effect.

View Article: PubMed Central - PubMed

Affiliation: Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

ABSTRACT

Background: Antihypertensive drugs are used to control blood pressure (BP) and reduce macro- and microvascular complications in hypertensive patients with diabetes.

Objectives: The present study aimed to compare the functional vascular changes in hypertensive patients with type 2 diabetes mellitus after 6 weeks of treatment with amlodipine or losartan.

Methods: Patients with a previous diagnosis of hypertension and type 2 diabetes mellitus were randomly divided into 2 groups and evaluated after 6 weeks of treatment with amlodipine (5 mg/day) or losartan (100 mg/day). Patient evaluation included BP measurement, ambulatory BP monitoring, and assessment of vascular parameters using applanation tonometry, pulse wave velocity (PWV), and flow-mediated dilation (FMD) of the brachial artery.

Results: A total of 42 patients were evaluated (21 in each group), with a predominance of women (71%) in both groups. The mean age of the patients in both groups was similar (amlodipine group: 54.9 ± 4.5 years; losartan group: 54.0 ± 6.9 years), with no significant difference in the mean BP [amlodipine group: 145 ± 14 mmHg (systolic) and 84 ± 8 mmHg (diastolic); losartan group: 153 ± 19 mmHg (systolic) and 90 ± 9 mmHg (diastolic)]. The augmentation index (30% ± 9% and 36% ± 8%, p = 0.025) and augmentation pressure (16 ± 6 mmHg and 20 ± 8 mmHg, p = 0.045) were lower in the amlodipine group when compared with the losartan group. PWV and FMD were similar in both groups.

Conclusions: Hypertensive patients with type 2 diabetes mellitus treated with amlodipine exhibited an improved pattern of pulse wave reflection in comparison with those treated with losartan. However, the use of losartan may be associated with independent vascular reactivity to the pressor effect.

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Related in: MedlinePlus

Patient selection flowchart. ANL: amlodipine; T2DM: type 2 diabetes mellitus;PMH: past medical history; CRF: chronic renal failure; LOS: losartan; DBP:diastolic blood pressure; SBP: systolic blood pressure.
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f01: Patient selection flowchart. ANL: amlodipine; T2DM: type 2 diabetes mellitus;PMH: past medical history; CRF: chronic renal failure; LOS: losartan; DBP:diastolic blood pressure; SBP: systolic blood pressure.

Mentions: Initially, 120 hypertensive patients with diabetes who met the inclusion criteriawere selected. Among these, 73 (61%) met the exclusion criteria and were withdrawnfrom the study. Accordingly, 47 subjects were included in the study and wererandomly divided into the losartan or amlodipine group. Because of 5 follow-upinterruptions during the evaluation period, only 42 patients completed the study (21in each group) (Figure 1).


Functional vascular study in hypertensive subjects with type 2 diabetes using losartan or amlodipine.

Pozzobon CR, Gismondi RA, Bedirian R, Ladeira MC, Neves MF, Oigman W - Arq. Bras. Cardiol. (2014)

Patient selection flowchart. ANL: amlodipine; T2DM: type 2 diabetes mellitus;PMH: past medical history; CRF: chronic renal failure; LOS: losartan; DBP:diastolic blood pressure; SBP: systolic blood pressure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126761&req=5

f01: Patient selection flowchart. ANL: amlodipine; T2DM: type 2 diabetes mellitus;PMH: past medical history; CRF: chronic renal failure; LOS: losartan; DBP:diastolic blood pressure; SBP: systolic blood pressure.
Mentions: Initially, 120 hypertensive patients with diabetes who met the inclusion criteriawere selected. Among these, 73 (61%) met the exclusion criteria and were withdrawnfrom the study. Accordingly, 47 subjects were included in the study and wererandomly divided into the losartan or amlodipine group. Because of 5 follow-upinterruptions during the evaluation period, only 42 patients completed the study (21in each group) (Figure 1).

Bottom Line: The mean age of the patients in both groups was similar (amlodipine group: 54.9 ± 4.5 years; losartan group: 54.0 ± 6.9 years), with no significant difference in the mean BP [amlodipine group: 145 ± 14 mmHg (systolic) and 84 ± 8 mmHg (diastolic); losartan group: 153 ± 19 mmHg (systolic) and 90 ± 9 mmHg (diastolic)].The augmentation index (30% ± 9% and 36% ± 8%, p = 0.025) and augmentation pressure (16 ± 6 mmHg and 20 ± 8 mmHg, p = 0.045) were lower in the amlodipine group when compared with the losartan group.However, the use of losartan may be associated with independent vascular reactivity to the pressor effect.

View Article: PubMed Central - PubMed

Affiliation: Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

ABSTRACT

Background: Antihypertensive drugs are used to control blood pressure (BP) and reduce macro- and microvascular complications in hypertensive patients with diabetes.

Objectives: The present study aimed to compare the functional vascular changes in hypertensive patients with type 2 diabetes mellitus after 6 weeks of treatment with amlodipine or losartan.

Methods: Patients with a previous diagnosis of hypertension and type 2 diabetes mellitus were randomly divided into 2 groups and evaluated after 6 weeks of treatment with amlodipine (5 mg/day) or losartan (100 mg/day). Patient evaluation included BP measurement, ambulatory BP monitoring, and assessment of vascular parameters using applanation tonometry, pulse wave velocity (PWV), and flow-mediated dilation (FMD) of the brachial artery.

Results: A total of 42 patients were evaluated (21 in each group), with a predominance of women (71%) in both groups. The mean age of the patients in both groups was similar (amlodipine group: 54.9 ± 4.5 years; losartan group: 54.0 ± 6.9 years), with no significant difference in the mean BP [amlodipine group: 145 ± 14 mmHg (systolic) and 84 ± 8 mmHg (diastolic); losartan group: 153 ± 19 mmHg (systolic) and 90 ± 9 mmHg (diastolic)]. The augmentation index (30% ± 9% and 36% ± 8%, p = 0.025) and augmentation pressure (16 ± 6 mmHg and 20 ± 8 mmHg, p = 0.045) were lower in the amlodipine group when compared with the losartan group. PWV and FMD were similar in both groups.

Conclusions: Hypertensive patients with type 2 diabetes mellitus treated with amlodipine exhibited an improved pattern of pulse wave reflection in comparison with those treated with losartan. However, the use of losartan may be associated with independent vascular reactivity to the pressor effect.

Show MeSH
Related in: MedlinePlus