Circulating microparticles and central blood pressure according to antihypertensive strategy

Abstract

OBJECTIVES:This prospective, randomized, open-label study aimed to compare the effects of antihypertensive treatment based on amlodipine or hydrochlorothiazide on the circulating microparticles and central blood pressure values of hypertensive patients.METHODS:The effects of treatments on circulating microparticles were assessed during monotherapy and after the consecutive addition of valsartan and rosuvastatin followed by the withdrawal of rosuvastatin. Each treatment period lasted for 30 days. Central blood pressure and pulse wave velocity were measured at the end of each period. Endothelial, monocyte, and platelet circulating microparticles were determined by flow cytometry. Central blood pressure values and pulse wave velocity were recorded at the end of each treatment period.RESULTS:No differences in brachial blood pressure were observed between the treatment groups throughout the study. Although similar central blood pressure values were observed during monotherapy, lower systolic and diastolic central blood pressure values and early and late blood pressure peaks were observed in the amlodipine arm after the addition of valsartan alone or combined with rosuvastatin. Hydrochlorothiazide-based therapy was associated with a lower number of endothelial microparticles throughout the study, whereas a higher number of platelet microparticles was observed after rosuvastatin withdrawal in the amlodipine arm.CONCLUSIONS:Despite similar brachial blood pressure values between groups throughout the study, exposure to amlodipine was associated with lower central blood pressure values after combination with valsartan, indicating a beneficial interaction. Differences between circulating microparticles were modest and were mainly influenced by rosuvastatin withdrawal in the amlodipine arm.

Role of Microparticles in Cardiovascular Disease: Implications for Endothelial Dysfunction, Thrombosis, and Inflammation

“…An increase in PMP was observed in the amlodipine group after discontinuation of rosuvastatin. 93 This study suggests an impact of concomitant therapies on microparticles.…”

Platelet-derived extracellular vesicles correlate with therapy-induced nocturnal blood pressure changes

“…In contrast, patients in whom the antihypertensive medication was up-titrated showed a decrease in BP levels along with lower levels of EVs. It is important to consider that in addition to decreasing BP levels, different antihypertensive medications have shown to have some pleiotropic effects including enhancement of nitric oxide activity, improvement of endothelial function, lowering of platelet activation, improvement of fibrinolytic balance and alleviation of the prothrombotic state [8,[36][37][38]. From our observations, it appears that changes in BP, irrespective of how these were achieved, are most closely associated with changes in EVs.…”

“…The use of specific antihypertensive drug classes has also been demonstrated to have an effect on EV formation [36–38,49]. Our sample size was probably not powerful enough to evaluate the impact of individual antihypertensive medications, as patients were commonly treated with dual or triple therapy, and we cannot evaluate the effect of each class separately.…”

Atherosclerosis severity in patients with familial hypercholesterolemia: The role of T and B lymphocytes

“…Circulating endothelium-, monocyte- and platelet-derived microparticles were determined as previously reported [ [23] , [24] , [25] ]. See Supplemental Methods for details.…”