[PP.22.14] ENALAPRIL/LERCANIDIPINE 20/20 MG COMPARED TO ENALAPRIL/HYDROCHLOROTIAZIDE 20/12.5 MG ON BLOOD PRESSURE VALUES AND METABOLIC PARAMETERS IN HYPERTENSIVE DIABETIC PATIENTS. (September 2017)

• Record Type: Journal Article
• Authors: Derosa, G.; Romano, D.; D'Angelo, A.; Maffioli, P.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523818.89904.e1
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: The aim of this study was to evaluate the effects of enalapril/lercanidipine 20/20 mg compared to enalapril/hydrochlorotiazide 20/12.5 mg on blood pressure values and metabolic parameters in patients with hypertension and type 2 diabetes mellitus. Design and method: We enrolled 161 hypertensive patients with mild systolic blood pressure (SBP) > or = 140 and <180 mmHg and diastolic blood pressure (DBP) > or = 90 and <105 mmHg and with type 2 diabetes mellitus. In the first phase of the study, all patients took enalapril/lercanidipine 20/10 mg, then, after 3 months, patients not reaching the targeted blood pressure values (< 140/85 mmHg), were randomized to take enalapril/lercanidipine 20/20 mg/day (44 patients) or enalapril/hydrochlorotiazide 20/12.5 mg/day (40 patients), for 12 months. We evaluated at randomization, and after 6 and 12 months: blood pressure, fasting plasma glucose (FPG), HOMA-index, glycated hemoglobin (HbA1c), and some adipocytokines linked to insulin-resistance like adiponectin and resistin. Results: Both treatments gave a reduction of systolic blood pressure compared to baseline (p < 0.01 for enalapril/lercanidipine 20/20 mg, and p < 0.05 for enalapril/hydrochlorotiazide 20/12.5 mg). Only enalapril/lercanidipine 20/20 mg gave a significant reduction of diastolic blood pressure compared to baseline (p < 0.05). Regarding HbA1c, FPG, and HOMA-IR, enalapril/lercanidipine 20/20 mg gave a better decrease of these values compared to enalapril/hydrochlorotiazide 20/12.5 mg (p < 0.05). Regarding adipocytochines, we recorded an increase of adiponectin, and a decrease of resistin with enalapril/lercanidipine 20/20 mg compared to enalapril/hydrochlorotiazide 20/12.5 mg. Conclusions: Enalapril/lercanidipine seems to better improve metabolic parameters in hypertensive patients with diabetes compared to enalapril/hydrochlorotiazide; for this reason, this combination should be preferred in this kind of patients.