[PP.35.33]: BARNIDIPINE COMPARED TO LERCANIDIPINE IN ADDITION TO LOSARTAN ON ENDOTHELIAL DAMAGE AND OXIDATIVE STRESS PARAMETERS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES MELLITUS. (June 2015)

• Record Type: Journal Article
• Authors: Derosa>, G.>; Querci, F.; Franzetti, I.; Ragonesi, P.D.; D'Angelo, A.; Maffioli, P.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000468829.12095.eb
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: To evaluate the effects of barnidipine or lercanidipine, in addition to losartan, on some markers linked to endothelial damage and oxidative stress in patients with hypertension and type 2 diabetes mellitus. Design and method: We enrolled 151 hypertensive patients with mild systolic blood pressure (SBP) > = 140 and <180 mmHg and diastolic blood pressure (DBP) > = 90 and <105 mmHg, type 2 diabetes mellitus, normocholesterolemic. 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 monthly, in addition, patients underwent ambulatory blood pressure monitoring (ABPM) at baseline, and at the end of the study. We also collected blood sample to assess: fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), some adipocytokines linked to endothelial damage such as high-sensitivity C-reactive protein (Hs-CRP), tumor necrosis factor-alfa (TNF-alfa), metalloproteinase-2 (MMP-2) and -9 (MMP-9), soluble vascular adhesion protein-1 (sVCAM-1), soluble intercellular adhesion protein-1 (sICAM-1). We also evaluated some markers of oxidative stress such as isoprostanes and paraoxonase-1 (PON-1). Results: One hundred and forty-three patients completed the study. Both barnidipine and lercanidipine resulted in a significant reduction in SBP and DBP, even if the blood pressure reduction obtained with barnidipine + losartan was greater than that obtained with lercanidipine + losartan (p < 0.05). Data recorded with ABPM showed a similar trend. Barnidipine + losartan reduced the levels of Hs-CRP and TNF-alfa (p < 0.05 vs baseline and vs lercanidipine + losartan). There were no significant differences between the two treatments on the levels of MMP-2 and -9. Barnidipine + losartan significantly reduced the levels of sVCAM-1 and sICAM-1, both compared to baseline and to lercanidipine + losartan (p < 0.05 for both). The levels of isoprostanes were reduced by barnidipine + losartan (p < 0.05 vs baseline and vs lercanidipine + losartan), while the levels of PON-1 remained unchanged. Conclusions: Other than giving a greater reduction of blood pressure, barnidipine + losartan gave an improvement of some parameters linked to endothelial damage and oxidative stress in diabetic and hypertensive patients.