Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine
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...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cardiologia (SBC)
2014-07-01
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| Series: | Arquivos Brasileiros de Cardiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014001900008&lng=en&tlng=en |
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| author | Cesar Romaro Pozzobon Ronaldo A. O. C. Gismondi Ricardo Bedirian Marcia Cristina Ladeira Mario Fritsch Neves Wille Oigman |
| author_facet | Cesar Romaro Pozzobon Ronaldo A. O. C. Gismondi Ricardo Bedirian Marcia Cristina Ladeira Mario Fritsch Neves Wille Oigman |
| author_sort | Cesar Romaro Pozzobon |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T14:33:28Z |
| format | Article |
| id | doaj.art-0fd714b90ed64174bbd1c50cc91863ca |
| institution | Directory Open Access Journal |
| issn | 1678-4170 |
| language | English |
| last_indexed | 2024-04-13T14:33:28Z |
| publishDate | 2014-07-01 |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-0fd714b90ed64174bbd1c50cc91863ca2022-12-22T02:43:07ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-41702014-07-011031515910.5935/abc.20140089S0066-782X2014001900008Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or AmlodipineCesar Romaro PozzobonRonaldo A. O. C. GismondiRicardo BedirianMarcia Cristina LadeiraMario Fritsch NevesWille OigmanBackground: 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014001900008&lng=en&tlng=enHipertensão / complicaçõesDiabetes Melito tipo 2 / complicaçõesAteroscleroseEndotélio / fisiopatologiaLosartana / uso terapêuticoAnlodipina / uso terapêutico |
| spellingShingle | Cesar Romaro Pozzobon Ronaldo A. O. C. Gismondi Ricardo Bedirian Marcia Cristina Ladeira Mario Fritsch Neves Wille Oigman Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine Arquivos Brasileiros de Cardiologia Hipertensão / complicações Diabetes Melito tipo 2 / complicações Aterosclerose Endotélio / fisiopatologia Losartana / uso terapêutico Anlodipina / uso terapêutico |
| title | Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine |
| title_full | Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine |
| title_fullStr | Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine |
| title_full_unstemmed | Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine |
| title_short | Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine |
| title_sort | functional vascular study in hypertensive subjects with type 2 diabetes using losartan or amlodipine |
| topic | Hipertensão / complicações Diabetes Melito tipo 2 / complicações Aterosclerose Endotélio / fisiopatologia Losartana / uso terapêutico Anlodipina / uso terapêutico |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014001900008&lng=en&tlng=en |
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