Effects of amlodipine and atorvastatin on endothelial vasoactive mediators in patients with metabolic syndrome
Abstract
Aims: to study the effects of the amlodipine and atorvastatin on the blood levels of vasoactive mediators in patients with metabolic syndrome (MS). Design and methods. There were included 60 patients with MS, hypertension and dyslipidemia who were randomized into three treatment groups: monotherapy with amlodipine, atorvastatin monotherapy and a combination therapy with amlodipine and atorvastatin. Office blood pressure, 24-hour ambulatory blood pressure monitoring, measurements of the NO metabolite levels, endothelin-1, thromboxane B2 (TxB2) and 6-keto-prostaglandin F1α (6-keto-PGF1α) were performed at baseline and after 24 weeks of the therapy.Results. Amlodipine and atorvastatin in monotherapy or in a combination were associated with the significant improvement of certain studied parameters. Amlodipine treatment significantly decreased TxB2 and 6-keto-PGF1α levels. There was a significant reduction of TxB2, 6-keto-PGF1a levels and increase of NO metabolite in atorvastatin group. Treatment with combination of amlodipine and atorvastatin was characterized by significant decrease of TxB2 and endothelin-1 and increase of NO metabolite.Conclusion. Amlodipine and atorvastatin treatment showed positive effects on the levels of vasoactive mediators thereby leading to the improvementof endothelial function in patients with MS.
About the Authors
N. V. Blinova
A.L.Myasnikov Institute of Clinical Cardiology, Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
V. P. Masenko
A.L.Myasnikov Institute of Clinical Cardiology, Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
I. E. Chazova
A.L.Myasnikov Institute of Clinical Cardiology, Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
References
1. Галицин П.В., Аксенова А.В., Елфимова Е.М. и др. Синдром обструктивного апноэ сна и дисфункция эндотелия. Системные гипертензии. 2013; 10 (3): 85-92.
2. Чазова И.Е., Мычка В.Б. Метаболический синдром. М.: Медиа Медика, 2008.
3. Sarafidis P.A, Bakris G.L. Review: insulin and endothelin: an interplay contributing to hypertension development? J Clin Endocrinol Metab 2007; 92: 379-85.
4. Campia U, Tesauro M, Cardillo C. Human obesity and endothelium - dependent responsiveness. Br J Pharmacol 2012; 165 (3): 561-73.
5. Чазова И.Е., Мычка В.Б. Ожирение. Руководство для врачей под ред. И.И.Дедова. М.: Медицинское информационное агентство, 2004.
6. Карпов Ю.А., Сорокин Е.В. Статины, эндотелий и сердечно - сосудистый риск. Рус. мед. журн. 2001; 9: 352-3.
7. Рекомендации экспертов ВНОК по диагностике и лечению МС (2-й пересмотр). Кардиоваск. терапия и профилактика. 2009; 7 (6); Прил. 2.
8. Mendizábal Y, Llorens S, Nava E. Hypertension in metabolic syndrome: vascular pathophysiology. Int J Hypertens 2013; 2013. doi: 10.1155/2013/230868. Epub 2013 Mar 20.
9. Morise T, Takeuchi Y, Kawano M et al. Increased plasma levels of immunoreactive endothelin and von Willebrand factor in NIDDM patients. Diabetes Care 1995; 18 (1): 87-9.
10. Da Silva A.A, Kuo J.J, Tallam L.S, Hall J.E. Role of endothelin-1 in blood pressure regulation in a rat model of visceral obesity and hypertension. Hypertension 2004; 43 (2): 383-7.
11. Graziani F, Biasucci L.M, Cialdella P et al. Thromboxane production in morbidly obese subjects. Am J Cardiol 2011; 107 (11): 1656-61.
12. Van Harmelen V, Eriksson A, Åström G et al. Vascular peptide endothelin-1 links fat accumulation with alterations of visceral adipocyte lipolysis. Diabetes 2008; 57 (2): 378-86.
13. Tessari P, Cecchet D, Artusi C et al. Roles of insulin, age, and asymmetric dimethylarginine, on nitric oxide synthesis in vivo. Diabetes 2013; Mar 8.
14. Caimi G, Hopps E, Montana M et al. Evaluation of nitric oxide metabolites in a group of subjects with metabolic syndrome. Diabetes Metab Syndr 2012; 6 (3): 132-5.
15. Куршаков А.А. Инсулинорезистентность и оксид азота на ранней стадии метаболического синдрома. Вестн. Санкт-Петербургской медицинской академии им. И.И.Мечникова. 2009; 2/1 (31): 125-9.
16. Siervo M, Bluck L.J. In vivo nitric oxide synthesis, insulin sensitivity, and asymmetric dimethylarginine in obese subjects without and with metabolic syndrome. Metabolism 2012; 61 (5): 680-8.
17. Hink U, Li H, Mollnau H et al. Mechanisms underlying endothelial dysfunction in diabetes mellitus. Circulation Research 2001; 88: e14.
18. Шестакова М.В. Дисфункция эндотелия - причина или следствие метаболического синдрома? РМЖ. 2001; 9: 2226.
19. Чазова И.Е., Мычка В.Б. Влияние гиполипидемической терапии на инсулинорезистентность у пациентов с метаболическим синдромом. Системные гипертензии. 2004; 1: 16-8.
20. Чазова И.Е., Ратова Л.Г. При всем богатстве выбора другой альтернативы нет. Исследование ЭТНА Плюс. Системные гипертензии. 2007; 2: 36-9.
21. Batova S, De Wever J, Godfraind T et al. The calcium channel blocker amlodipine promotes the unclamping of eNOS from caveolin in endothelial cells. Cardiovasc Res 2006; 71 (3): 478-85.
22. Taddei S, Virdis A, Ghiadoni L et al. Effect of calcium antagonist or beta blockade treatment on nitric oxide - dependent vasodilation and oxidative stress in essential hypertensive patients. J Hypertens 2001; 19 (8): 1379-86.
23. Rashidi B, Mohammadi M, Mirzaei F et al. Amlodipine treatment decreases plasma and carotid artery tissue levels of endothelin-1 in atherosclerotic rabbits. Pathophysiology 2011; 18 (2): 137-42.
24. Kara-Perz H, Kosicka T, Perz S. Is hypotensive effectiveness of amlodipine therapy in smokers connected with endothelin-1 (ET-1) concentration? Przegl Lek 2007; 64 (10): 703-5.
Review
For citations:
Blinova N.V., Masenko V.P., Chazova I.E. Effects of amlodipine and atorvastatin on endothelial vasoactive mediators in patients with metabolic syndrome. Systemic Hypertension. 2015;12(1):37-42. (In Russ.)
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