Korean Circulation Journal

  • 제40권12호
  • /
  • Pages.632-638
  • /
  • 2010
  • /
  • 1738-5520(pISSN)
  • /
  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
권호 표지
DOI QR코드

DOI QR Code

Effect of Lacidipine on Blood Pressure and Endothelial Function in Mild-to-Moderate Essential Hypertension Patients With Diabetes in Korea

  • Kim, Dae-Hee (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Oh, Il-Young (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Lee, Hae-Young (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim, Yong-Jin (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim, Hyo-Soo (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim, Cheol-Ho (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Oh, Byung-Hee (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim, Kwon-Sam (Department of Internal Medicine, Kyung Hee University College of Medicine) ;
  • Kim, Doo-Il (Department of Internal Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Kim, Young-Dae (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Ryu, Kyu-Hyung (Department of Internal Medicine, Konkuk University College of Medicine) ;
  • Park, Si-Hoon (Department of Internal Medicine, Ewha Womans University College of Medicine, Mokdong Hospital) ;
  • Baek, Sang-Hong (Department of Internal Medicine, The Catholic University College of Medicine, Seoul St. Mary's Hospital) ;
  • Shin, Dong-Gu (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Shim, Wan-Joo (Department of Internal Medicine, Korea University College of Medicine, Anam Hospital) ;
  • Ahn, Tae-Hoon (Department of Internal Medicine, Gachon University Gil Hospital) ;
  • Oh, Seok-Kyu (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Lee, Seung-Hwan (Department of Internal Medicine, Yonsei University Wonju Christian Hospital) ;
  • Lee, Sung-Yun (Department of Internal Medicine, Inje University College of Medicine, IIsan Paik Hospital) ;
  • Jeong, Myung-Ho (Department of Internal Medicine, Chonnam National University College of Medicine) ;
  • Chung, Wook-Sung (Department of Internal Medicine, The Catholic University College of Medicine, Seoul St. Mary's Hospital) ;
  • Jeong, Jun-Young (Department of Internal Medicine, Eulji University College of Medicine) ;
  • Choi, So-Yeon ;
  • Choi, Si-Wan (Department of Internal Medicine, Chungnam National University College of Medicine) ;
  • Hyon, Min-Su (Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • 투고 : 2010.03.03
  • 심사 : 2010.05.27
  • 발행 : 2010.12.30
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: The aim of this study was to evaluate the efficacy of lacidipine in reducing blood pressure (BP) and to determine its effect on endothelial function in mild-to-moderate hypertensive patients with type 2 diabetes mellitus (DM). Subjects and Methods: This was a prospective, multicenter, open-label, single-arm study, enrolling 290 patients with mild-to-moderate hypertension and type 2 DM. Patients were initially treated with 2 mg lacidipine orally once daily for 4 weeks, which was then increased as necessary every 4 weeks to a maximal dose of 6 mg daily. The primary endpoint was the mean change in systolic blood pressure (SBP) from baseline after 12 weeks of treatment. Secondary endpoints included mean changes in diastolic blood pressure (DBP), flow-mediated vasodilatation (FMD), and serum concentrations of biochemical markers such as high-sensitivity C-reactive protein (hs-CRP), monocyte chemo-attractant protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), and plasminogen activator inhibitor-1 (PAI-1). Results: Lacidipine treatment significantly reduced SBP by -13.4${\pm}$13.0 mmHg (p<0.001) and DBP by -6.2${\pm}$9.3 mmHg (p<0.001). Lacidipine treatment did not improve endothelial-dependent vasodilatation, despite significantly improved nitroglycerin-induced, endothelial-independent vasodilatation. MCP-1 levels significantly decreased from 283.66${\pm}$110.08 pg/mL to 257.83${\pm}$100.23 pg/mL (p<0.001); whereas there were no significant changes in the levels of hs-CRP, MMP-9, or PAI-1. Conclusion: Twelve weeks of treatment with lacidipine was effective and well tolerated in mild-to-moderate hypertensive patients with type 2 DM. In spite of inducing a significant reduction in MCP-1 levels, lacidipine did not improve endothelial function.

키워드

참고문헌

  1. Arauz-Pacheco C, Parrott MA, Raskin P. Treatment of hypertension in adults with diabetes. Diabetes Care 2003;26(Suppl 1):S80-2. https://doi.org/10.2337/diacare.26.2007.S80
  2. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Tr-eatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289: 2560-72. https://doi.org/10.1001/jama.289.19.2560
  3. Kim KI, Kim Y, Kim HJ, et al. Current status and characteristics of hypertension treatment by primary physicians in Korea: data from Korean Epidemiology Study on Hypertension (KEY Study). Am J Hypertens 2008;21:884-9. https://doi.org/10.1038/ajh.2008.191
  4. Sowers JR, Haffner S. Treatment of cardiovascular and renal risk factors in the diabetic hypertensive. Hypertension 2002;40:781-8. https://doi.org/10.1161/01.HYP.0000042097.39655.B7
  5. Taddei S, Virdis A, Ghiadoni L, Sudano I, Salvetti A. Effects of antihypertensive drugs on endothelial dysfunction: clinical implications. Drugs 2002;62:265-84. https://doi.org/10.2165/00003495-200262020-00003
  6. Zanchetti A, Bond MG, Hennig M, et al. Absolute and relative changes in carotid intima-media thickness and atherosclerotic plaques during long-term antihypertensive treatment: further results of the European Lacidipine Study on Atherosclerosis (ELSA). J Hypertens 2004;22: 1201-12. https://doi.org/10.1097/00004872-200406000-00022
  7. Zanchetti A, Bond MG, Hennig M, et al. Calcium antagonist lacidipine slows down progression of asymptomatic carotid atherosclerosis: principal results of the European Lacidipine Study on Atherosclerosis (ELSA), a randomized, double-blind, long-term trial. Circulation 2002; 106:2422-7. https://doi.org/10.1161/01.CIR.0000039288.86470.DD
  8. Frattola A, Parati G, Castiglioni P, et al. Lacidipine and blood pressure variability in diabetic hypertensive patients. Hypertension 2000;36: 622-8. https://doi.org/10.1161/01.HYP.36.4.622
  9. Corretti MC, Anderson TJ, Benjamin EJ, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol 2002;39:257-65.
  10. Salako BL, Kadiri S, Walker O, Fehintola FA. Evaluation of lacidipine (a calcium blocker) in the treatment of hypertension in black African people: a double-blind comparison with hydrochlorothiazide. Afr J Med Med Sci 1998;27:73-5.
  11. Tcherdakoff P. French large-scale study evaluating the tolerability and efficacy of lacidipine. J Cardiovasc Pharmacol 1995;25(Suppl 3):S27- 32. https://doi.org/10.1097/00005344-199500003-00007
  12. Kim DH, Oh SI, Kim YK, Choi SW, Yoo WS. Efficacy and safety of ni-fedipine gastrointestinal therapeutic system (Adalat OROS) in patients with mild to moderate essential hypertension. Korean Circ J 1992; 22:488-93. https://doi.org/10.4070/kcj.1992.22.3.488
  13. Choi YJ, Lee MM, Choe SJ, et al. A randomized, double-blind clinical trial to determine the efficacy of carvedilol vs. atenolol in patients with stage 1 to 2 essential hypertension. Korean Circ J 1998;28:359-65. https://doi.org/10.4070/kcj.1998.28.3.359
  14. Jin SB, Rhee YW, Chang SW, Kim KC, Kim SP, Song CS. Effects of di-hydrochlorothiazide, propranolol, and prazosin on serum lipids in pa-tients with essential hypertension. Korean Circ J 1985;15:329-36. https://doi.org/10.4070/kcj.1985.15.2.329
  15. Cheong HJ, Kang HS, Choue CW, et al. Antihypertensive effects and sa-fety of isradipine in patients with essential hypertension. Korean Circ J 1993;23:741-9. https://doi.org/10.4070/kcj.1993.23.5.741
  16. Park SW, Doo YC, Kim WH, et al. Amlodipine monotherapy in patients with mild to moderate essential hypertension. Korean Circ J 1992; 22:852-7. https://doi.org/10.4070/kcj.1992.22.5.852
  17. Pieper GM, Gross GJ. Oxygen free radicals abolish endothelium-dependent relaxation in diabetic rat aorta. Am J Physiol 1988;255:H825-33.
  18. Tesfamariam B, Cohen RA. Free radicals mediate endothelial cell dysfunction caused by elevated glucose. Am J Physiol 1992;263:H321-6.
  19. Dai FX, Diederich A, Skopec J, Diederich D. Diabetes-induced endothelial dysfunction in streptozotocin-treated rats: role of prostaglandin endoperoxides and free radicals. J Am Soc Nephrol 1993;4:1327-36.
  20. Yugar-Toledo JC, Tanus-Santos JE, Sabha M, et al. Uncontrolled hypertension, uncompensated type II diabetes, and smoking have different patterns of vascular dysfunction. Chest 2004;125:823-30. https://doi.org/10.1378/chest.125.3.823
  21. Balletshofer BM, Goebbel S, Rittig K, et al. Intense cholesterol lowering therapy with a HMG-CoA reductase inhibitor does not improve nitric oxide dependent endothelial function in type-2-diabetes: a multicenter, randomised, double-blind, three-arm placebo-controlled clini-cal trial. Exp Clin Endocrinol Diabetes 2005;113:324-30. https://doi.org/10.1055/s-2005-865642
  22. Stroes ES, Koomans HA, de Bruin TW, Rabelink TJ. Vascular function in the forearm of hypercholesterolaemic patients off and on lipid-lowering medication. Lancet 1995;346:467-71. https://doi.org/10.1016/S0140-6736(95)91322-X
  23. Economides PA, Caselli A, Tiani E, Khaodhiar L, Horton ES, Veves A. The effects of atorvastatin on endothelial function in diabetic patients and subjects at risk for type 2 diabetes. J Clin Endocrinol Metab 2004; 89:740-7. https://doi.org/10.1210/jc.2003-031116
  24. Guerci B, Bohme P, Kearney-Schwartz A, Zannad F, Drouin P. Endothelial dysfunction and type 2 diabetes: part 2. altered endothelial func-tion and the effects of treatments in type 2 diabetes mellitus. Diabetes Metab 2001;27:436-47.
  25. Braunersreuther V, Mach F, Steffens S. The specific role of chemokines in atherosclerosis. Thromb Haemost 2007;97:714-21.
  26. Sardo MA, Campo S, Mandraffino G, et al. Tissue factor and monocyte chemoattractant protein-1 expression in hypertensive individuals with normal or increased carotid intima-media wall thickness. Clin Chem 2008;54:814-23. https://doi.org/10.1373/clinchem.2007.095547
  27. Bae JH, Bassenge E, Lim DM, Synn YC, Kim KY, Schwemmer M. Ef-fects of lacidipine on vascular responses in patients with coronary ar-tery disease. Int J Cardiol 2005;101:377-83. https://doi.org/10.1016/j.ijcard.2004.03.046
  28. Koh KK, Han SH, Chung WJ, et al. Comparison of effects of losartan, irbesartan, and candesartan on flow-mediated brachial artery dilation and on inflammatory and thrombolytic markers in patients with syste-mic hypertension. Am J Cardiol 2004;93:1432-5, A10. https://doi.org/10.1016/j.amjcard.2004.02.050
  29. Juhan-Vague I, Alessi MC, Vague P. Thrombogenic and fibrinolytic fac-tors and cardiovascular risk in non-insulin-dependent diabetes mellitus. Ann Med 1996;28:371-80.
  30. Kaikita K, Fogo AB, Ma L, Schoenhard JA, Brown NJ, Vaughan DE. Plasminogen activator inhibitor-1 deficiency prevents hypertension and vascular fibrosis in response to long-term nitric oxide synthase inhibition. Circulation 2001;104:839-44. https://doi.org/10.1161/hc3301.092803

피인용 문헌

  1. Potential Protective Role of Blood Pressure-Lowering Drugs on the Balance between Hemostasis and Fibrinolysis in Hypertensive Patients at Rest and During Exercise vol.19, pp.2, 2010, https://doi.org/10.1007/s40256-018-00316-2