Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine

Abstract

BackgroundAntihypertensive drugs are used to control blood pressure (BP) and reduce macro- and microvascular complications in hypertensive patients with diabetes.ObjectivesThe 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.MethodsPatients 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.ResultsA 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.ConclusionsHypertensive 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.

Multi‐domain analysis of microvascular flow motion dynamics in NAFLD

“…With calcium channel blocker use, the distribution of the relative power over the five frequency bands changed significantly. The majority of the power in the LDF signal lay in the heart beat rather than the LF bands indicating higher pulse wave transmission . Myogenic and neurogenic contributions were suppressed as was that in the respiratory band.…”

Role of Laser Doppler for the Evaluation of Pedal Microcirculatory Function in Diabetic Neuropathy Patients

“…We were also not able to strictly control and exclude hypertensive patients, since hypertension can also cause arteriolar remodeling to a certain extent by means of reactive oxygen species, which may act as a confounder. However, all our hypertensive patients were well‐controlled with antihypertensive medications for more than six months, as reflected by the similarities in systolic blood pressures, which is important since previous studies have shown that the use of antihypertensive medications have the effect of reversing microvascular rarefaction to levels approaching normal values and improving microvascular endothelial function following blood pressure normalization for six months . Otherwise, our study subjects were well matched and homogenously selected, and the reproducibility of the tests was well controlled, with tests being performed by a single operator using a standardized protocol to reduce inter‐ and intra‐observer variability.…”

Дисфункція Лівого Шлуночка У Хворих З Артеріальною Гіпертензією Та Діабетичною Нефропатією В Динаміці Лікування

“…Крім того, поєднання АГ та ЦД 2 спричинює прогресування ДН [12]. Проте вчасно розпочате лікування АГ сприяє зниженню прогресування ДН [11]. Доцільним є призначення інгібіторів ангіотензинперетворюючого ферменту (іАПФ) пацієнтам з ДН [6].…”