scholarly journals Possible beneficial effects of amlodipine, lisinopril, and their Combination on lipid profile in hypertensive patients

2009 ◽  
Vol 33 (2) ◽  
pp. 126-137
Author(s):  
Fadia Y. Alhamdani
Keyword(s):  
Blood Pressure ◽  
Angiotensin Converting Enzyme ◽  
Lipid Profile ◽  
Poor Response ◽  
Serum Levels ◽  
Combination Group ◽  
Converting Enzyme ◽  
Double Blind ◽  
Beneficial Effects ◽  
Long Acting

It is well known that monotherapy does not provide therapeutic response in all hypertensive. Somepatients show an excellent response, while in others there is a poor response. Combinationantihypertensive therapy is administered when blood pressure is inadequately controlled bymonotherapy to achieve a balanced and additive antihypertensive effect with minimum adverse effects.Both angiotensin converting enzyme (ACE) inhibitors and dihydropyridine type of calcium antagonistsare well established and widely used in monotherapy. An understanding of differences in themechanism of action of these agents allows a logical approach for the use of these agents as acombination therapy. This study was designed to evaluate the possible beneficial effects of long actingcalcium channel blocker, amlodipine and the long acting Angiotensin converting enzyme (ACE)inhibitor, lisinopril given either alone or in combination in patients with essential hypertension on lipidprofile (LDL-C and HDL-C) and on other parameters using a randomized double blind, crossoverstudy. The study includes 150 patients with systolic blood pressure (SBP)>140 mmHg and diastolicblood pressure (DBP) >90 mmHg received amlodipine 5 mg, lisinopril 5 mg and their combinationprior randomization schedule. Systolic, diastolic blood pressure and pulse rate were recorded at weeklyintervals while, serum levels of urea, creatinine, LDL-C and HDL-C where recorded at monthlyintervals, the duration of this study was 3 months. Results were obtained using paired students t-test,differences were considered significant with (p<0.05).A significant decline in SBP and DBP in all treatment groups (p<0.05) was recorded, the reductiontend to be more pronounced in the combination group. Moreover, there was a significant effect ofcombination on the heart rate, serum level of urea and creatinine, beside that, the level of HDL wassignificantly elevated with amlodipine and combination. We concluded that combination had additionalblood pressure lowering effect when compared either with amlodipine or lisinopril alone, in addition tothe greater effect on lipid profile which demonstrated that this combination is potentialantiatherosclerotic agent.

scholarly journals Effects of combined statin and ACE inhibitor therapy on endothelial function and blood pressure in essential hypertension - a randomised double-blind, placebo controlled crossover study

2019 ◽  
Vol 20 (3) ◽  
pp. 147032031986889 ◽  
Author(s):  
Piotr Ruszkowski ◽  
Anna Masajtis-Zagajewska ◽  
Michał Nowicki
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Angiotensin Converting Enzyme ◽  
Endothelial Function ◽  
Enzyme Inhibitor ◽  
Converting Enzyme ◽  
C Reactive Protein ◽  
Double Blind ◽  
Hypertensive Patients ◽  
Reactive Protein

Background: The aim of this study was to compare the influence of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors on endothelial function and blood pressure in patients with essential hypertension on long-term angiotensin-converting enzyme inhibitor therapy. Method: The study was designed as a prospective, double-blind, randomised, placebo controlled, crossover clinical trial. Twenty patients with essential hypertension were treated with an angiotensin-converting enzyme inhibitor; the control group included 10 healthy subjects. Hypertensive patients received in random order 80 mg of fluvastatin daily or placebo for 6 weeks. The following parameters were assessed at baseline and after each treatment period: serum lipids, flow-mediated vasodilation, activity of von Willebrand factor, concentration of vascular endothelial growth factor, C-reactive protein and 24-hour blood pressure profile. Results: Hypertensive patients did not differ from healthy subjects with respect to age, body mass and biochemical parameters, with the exception of C-reactive protein, which was higher in hypertensive patients ( P=0.02). After statin therapy, low-density lipoprotein cholesterol ( P<0.0001), C-reactive protein ( P=0.03), von Willebrand factor ( P=0.03) and vascular endothelial growth factor ( P<0.01) decreased and flow-mediated vasodilation improved ( P<0.001). Statins had no significant effect on blood pressure. Conclusions: Statins added to angiotensin-converting enzyme inhibitors may improve endothelial function and ameliorate inflammation independently of blood pressure.

scholarly journals Modern combination antihypertensive pharmacotherapy

2018 ◽  
Vol 15 (4) ◽  
pp. 30-33
Author(s):  
O A Mubarakshina ◽  
M N Somova ◽  
G A Batishcheva
Keyword(s):  
Blood Pressure ◽  
Angiotensin Converting Enzyme ◽  
Channel Blocker ◽  
Fixed Combination ◽  
Enzyme Inhibitor ◽  
Target Blood Pressure ◽  
Converting Enzyme ◽  
European Guidelines ◽  
Dihydropyridine Calcium Channel Blocker ◽  
Long Acting

Achievement of target blood pressure levels is one of the main issues in antihypertensive pharmacotherapy. The article presents updated 2018 European Guidelines recommendations on target blood pressure levels in antihypertensive therapy and combined antihypertensive pharmacotherapy advantages. Modern fixed combinations including those with three active agents are discussed. A review of studies that show effectiveness and safety of long acting dihydropyridine calcium channel blocker amlodipine, thiazid-like diuretic indapamide, and angiotensin-converting enzyme inhibitor perindopril arginine fixed combination is presented

scholarly journals Blood Pressure and Metabolic Effect of a Combination of Lercanidipine with Different Antihypertensive Drugs in Clinical Practice

2012 ◽  
Vol 11 (1) ◽  
pp. 36-40
Author(s):  
Arrigo F.G. Cicero ◽  
Beatrice Gerocarni ◽  
Martina Rosticci ◽  
Claudio Borgh
Keyword(s):  
Blood Pressure ◽  
Clinical Practice ◽  
Angiotensin Ii ◽  
Angiotensin Converting Enzyme ◽  
Plasma Glucose ◽  
Antihypertensive Drugs ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor

The aim of this study is to assess the blood pressure (BP) and metabolic effects of lercanidipine when combined with other classes of first-line antihypertensive drugs in day-to-day clinical practice. For this study, we consecutively enrolled 162 patients with uncomplicated primary hypertension, who are partial responders to the treatment with lercanidipine over a period of 24 months. Patients were then allocated to the combination of lercanidipine (10–20 mg/day) with β-blockers, diuretics, angiotensin-converting enzyme inhibitors, and angiotensin-II receptor blockers according to compelling indications (if any) and/or suggestions of European Society of Hypertension–European Society of Cardiology (ESH–ESC) guidelines. All the enrolled patients completed the study and no adverse drug reaction was registered during the research period. The association of a second drug with lercanidipine determined an additional BP decrease of either systolic BP or diastolic BP independently from the type of drug added (P always <0.05). The additional effect of lercanidipine appears widely distributed with no significant differences in the size of BP decrease. From the metabolic point of view, the addition of a second drug did not determine a significant variation in the serum levels of total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (P always >0.05). Conversely, a significant decrease in fasting plasma glucose and serum levels of triglycerides has been observed in patients where lercanidipine has been combined with an angiotensin-converting enzyme inhibitor or an angiotensin-II receptor blocker. In conclusion, in our study we observed that lercanidipine-based protocols are well tolerated and efficacious in reducing BP. Moreover, the association of lercanidipine with renin–angiotensin system blockers is also associated with significant improvements in triglycerides and fasting plasma glucose.

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