Effect of Lacidipine on Blood Pressure and Endothelial Function in Mild-to-Moderate Essential Hypertension Patients With Diabetes in Korea.

Abstract

BACKGROUND AND OBJECTIVES:

The aim of this study was to evaluate the efficacy of lacidipine in reducing blood pressure (BP) and to determine its effect on endothelial function in mild-to-moderate hypertensive patients with type 2 diabetes mellitus (DM).

SUBJECTS AND METHODS:

This was a prospective, multicenter, open-label, single-arm study, enrolling 290 patients with mild-to-moderate hypertension and type 2 DM. Patients were initially treated with 2 mg lacidipine orally once daily for 4 weeks, which was then increased as necessary every 4 weeks to a maximal dose of 6 mg daily. The primary endpoint was the mean change in systolic blood pressure (SBP) from baseline after 12 weeks of treatment. Secondary endpoints included mean changes in diastolic blood pressure (DBP), flow-mediated vasodilatation (FMD), and serum concentrations of biochemical markers such as high-sensitivity C-reactive protein (hs-CRP), monocyte chemo-attractant protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), and plasminogen activator inhibitor-1 (PAI-1).

RESULTS:

Lacidipine treatment significantly reduced SBP by -13.4±13.0 mmHg (p<0.001) and DBP by -6.2±9.3 mmHg (p<0.001). Lacidipine treatment did not improve endothelial-dependent vasodilatation, despite significantly improved nitroglycerin-induced, endothelial-independent vasodilatation. MCP-1 levels significantly decreased from 283.66±110.08 pg/mL to 257.83±100.23 pg/mL (p<0.001); whereas there were no significant changes in the levels of hs-CRP, MMP-9, or PAI-1.

CONCLUSION:

Twelve weeks of treatment with lacidipine was effective and well tolerated in mild-to-moderate hypertensive patients with type 2 DM. In spite of inducing a significant reduction in MCP-1 levels, lacidipine did not improve endothelial function.

• Authors: Dae-Hee Kim, Il-Young Oh, Hae-Young Lee, Yong-Jin Kim, Hyo-Soo Kim, Cheol-Ho Kim, Byung-Hee Oh, Kwon-Sam Kim, Doo-Il Kim, Young-Dae Kim, Kyu-Hyung Ryu, Si-Hoon Park, Sang-Hong Baek, Dong-Gu Shin, Wan Joo Shim, Tae-Hoon Ahn, Seok-Kyu Oh, Seung-Hwan Lee, Sung-Yun Lee, Myung-Ho Jeong, Wook-Sung Chung, Jun-Young Jeong, So-Yeon Choi, Si-Wan Choi, Min-Su Hyon
• Journal: Korean circulation journal (Korean Circ J) Vol. 40 Issue 12 Pg. 632-8 (Dec 2010) ISSN: 1738-5555 [Electronic] Korea (South)
• PMID: 21267385 (Publication Type: Journal Article)