Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in Diabetics

Detalhes bibliográficos
Autor(a) principal: Gismondi,Ronaldo Altenburg
Data de Publicação: 2015
Outros Autores: Bedirian,Ricardo, Pozzobon,Cesar Romaro, Ladeira,Márcia Cristina, Oigman,Wille, Neves,Mário Fritsch
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos Brasileiros de Cardiologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015002500597
Resumo: Abstract Background: Studies suggest that statins have pleiotropic effects, such as reduction in blood pressure, and improvement in endothelial function and vascular stiffness. Objective: To analyze if prior statin use influences the effect of renin-angiotensin-aldosterone system inhibitors on blood pressure, endothelial function, and vascular stiffness. Methods: Patients with diabetes and hypertension with office systolic blood pressure ≥ 130 mmHg and/or diastolic blood pressure ≥ 80 mmHg had their antihypertensive medications replaced by amlodipine during 6 weeks. They were then randomized to either benazepril or losartan for 12 additional weeks while continuing on amlodipine. Blood pressure (assessed with ambulatory blood pressure monitoring), endothelial function (brachial artery flow-mediated dilation), and vascular stiffness (pulse wave velocity) were evaluated before and after the combined treatment. In this study, a post hoc analysis was performed to compare patients who were or were not on statins (SU and NSU groups, respectively). Results: The SU group presented a greater reduction in the 24-hour systolic blood pressure (from 134 to 122 mmHg, p = 0.007), and in the brachial artery flow-mediated dilation (from 6.5 to 10.9%, p = 0.003) when compared with the NSU group (from 137 to 128 mmHg, p = 0.362, and from 7.5 to 8.3%, p = 0.820). There was no statistically significant difference in pulse wave velocity (SU group: from 9.95 to 9.90 m/s, p = 0.650; NSU group: from 10.65 to 11.05 m/s, p = 0.586). Conclusion: Combined use of statins, amlodipine, and renin-angiotensin-aldosterone system inhibitors improves the antihypertensive response and endothelial function in patients with hypertension and diabetes.
id SBC-1_f8c409cd2c0786ff005baad3da01d165
oai_identifier_str oai:scielo:S0066-782X2015002500597
network_acronym_str SBC-1
network_name_str Arquivos Brasileiros de Cardiologia (Online)
repository_id_str
spelling Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in DiabeticsHypertensionRenin-Angiotensin System/drug effectsEndothelium/physiopathologyDiabetes MellitusAbstract Background: Studies suggest that statins have pleiotropic effects, such as reduction in blood pressure, and improvement in endothelial function and vascular stiffness. Objective: To analyze if prior statin use influences the effect of renin-angiotensin-aldosterone system inhibitors on blood pressure, endothelial function, and vascular stiffness. Methods: Patients with diabetes and hypertension with office systolic blood pressure ≥ 130 mmHg and/or diastolic blood pressure ≥ 80 mmHg had their antihypertensive medications replaced by amlodipine during 6 weeks. They were then randomized to either benazepril or losartan for 12 additional weeks while continuing on amlodipine. Blood pressure (assessed with ambulatory blood pressure monitoring), endothelial function (brachial artery flow-mediated dilation), and vascular stiffness (pulse wave velocity) were evaluated before and after the combined treatment. In this study, a post hoc analysis was performed to compare patients who were or were not on statins (SU and NSU groups, respectively). Results: The SU group presented a greater reduction in the 24-hour systolic blood pressure (from 134 to 122 mmHg, p = 0.007), and in the brachial artery flow-mediated dilation (from 6.5 to 10.9%, p = 0.003) when compared with the NSU group (from 137 to 128 mmHg, p = 0.362, and from 7.5 to 8.3%, p = 0.820). There was no statistically significant difference in pulse wave velocity (SU group: from 9.95 to 9.90 m/s, p = 0.650; NSU group: from 10.65 to 11.05 m/s, p = 0.586). Conclusion: Combined use of statins, amlodipine, and renin-angiotensin-aldosterone system inhibitors improves the antihypertensive response and endothelial function in patients with hypertension and diabetes.Sociedade Brasileira de Cardiologia - SBC2015-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015002500597Arquivos Brasileiros de Cardiologia v.105 n.6 2015reponame:Arquivos Brasileiros de Cardiologia (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.5935/abc.20150123info:eu-repo/semantics/openAccessGismondi,Ronaldo AltenburgBedirian,RicardoPozzobon,Cesar RomaroLadeira,Márcia CristinaOigman,WilleNeves,Mário Fritscheng2016-01-06T00:00:00Zoai:scielo:S0066-782X2015002500597Revistahttp://www.arquivosonline.com.br/https://old.scielo.br/oai/scielo-oai.php||arquivos@cardiol.br1678-41700066-782Xopendoar:2016-01-06T00:00Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC)false
dc.title.none.fl_str_mv Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in Diabetics
title Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in Diabetics
spellingShingle Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in Diabetics
Gismondi,Ronaldo Altenburg
Hypertension
Renin-Angiotensin System/drug effects
Endothelium/physiopathology
Diabetes Mellitus
title_short Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in Diabetics
title_full Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in Diabetics
title_fullStr Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in Diabetics
title_full_unstemmed Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in Diabetics
title_sort Renin-Angiotensin System Blockade Associated with Statin Improves Endothelial Function in Diabetics
author Gismondi,Ronaldo Altenburg
author_facet Gismondi,Ronaldo Altenburg
Bedirian,Ricardo
Pozzobon,Cesar Romaro
Ladeira,Márcia Cristina
Oigman,Wille
Neves,Mário Fritsch
author_role author
author2 Bedirian,Ricardo
Pozzobon,Cesar Romaro
Ladeira,Márcia Cristina
Oigman,Wille
Neves,Mário Fritsch
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Gismondi,Ronaldo Altenburg
Bedirian,Ricardo
Pozzobon,Cesar Romaro
Ladeira,Márcia Cristina
Oigman,Wille
Neves,Mário Fritsch
dc.subject.por.fl_str_mv Hypertension
Renin-Angiotensin System/drug effects
Endothelium/physiopathology
Diabetes Mellitus
topic Hypertension
Renin-Angiotensin System/drug effects
Endothelium/physiopathology
Diabetes Mellitus
description Abstract Background: Studies suggest that statins have pleiotropic effects, such as reduction in blood pressure, and improvement in endothelial function and vascular stiffness. Objective: To analyze if prior statin use influences the effect of renin-angiotensin-aldosterone system inhibitors on blood pressure, endothelial function, and vascular stiffness. Methods: Patients with diabetes and hypertension with office systolic blood pressure ≥ 130 mmHg and/or diastolic blood pressure ≥ 80 mmHg had their antihypertensive medications replaced by amlodipine during 6 weeks. They were then randomized to either benazepril or losartan for 12 additional weeks while continuing on amlodipine. Blood pressure (assessed with ambulatory blood pressure monitoring), endothelial function (brachial artery flow-mediated dilation), and vascular stiffness (pulse wave velocity) were evaluated before and after the combined treatment. In this study, a post hoc analysis was performed to compare patients who were or were not on statins (SU and NSU groups, respectively). Results: The SU group presented a greater reduction in the 24-hour systolic blood pressure (from 134 to 122 mmHg, p = 0.007), and in the brachial artery flow-mediated dilation (from 6.5 to 10.9%, p = 0.003) when compared with the NSU group (from 137 to 128 mmHg, p = 0.362, and from 7.5 to 8.3%, p = 0.820). There was no statistically significant difference in pulse wave velocity (SU group: from 9.95 to 9.90 m/s, p = 0.650; NSU group: from 10.65 to 11.05 m/s, p = 0.586). Conclusion: Combined use of statins, amlodipine, and renin-angiotensin-aldosterone system inhibitors improves the antihypertensive response and endothelial function in patients with hypertension and diabetes.
publishDate 2015
dc.date.none.fl_str_mv 2015-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015002500597
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015002500597
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.5935/abc.20150123
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Cardiologia - SBC
publisher.none.fl_str_mv Sociedade Brasileira de Cardiologia - SBC
dc.source.none.fl_str_mv Arquivos Brasileiros de Cardiologia v.105 n.6 2015
reponame:Arquivos Brasileiros de Cardiologia (Online)
instname:Sociedade Brasileira de Cardiologia (SBC)
instacron:SBC
instname_str Sociedade Brasileira de Cardiologia (SBC)
instacron_str SBC
institution SBC
reponame_str Arquivos Brasileiros de Cardiologia (Online)
collection Arquivos Brasileiros de Cardiologia (Online)
repository.name.fl_str_mv Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC)
repository.mail.fl_str_mv ||arquivos@cardiol.br
_version_ 1752126565723930624