Effects of candesartan in hypertensive patients with type 2 diabetes mellitus on inflammatory parameters and their relationship to pulse pressureReport as inadecuate




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Cardiovascular Diabetology

, 11:118

First Online: 03 October 2012Received: 01 August 2012Accepted: 30 September 2012

Abstract

BackgroundAngiotensin receptor blockers ARBs are reported to provide direct protection to many organs by controlling inflammation and decreasing oxidant stress in patients without arteriosclerosis. This study aimed to evaluate 1 whether an ARB candesartan decreases values for inflammatory parameters in hypertensive patients with type 2 diabetes mellitus of long duration accompanied by arteriosclerosis and 2 whether there any predictors of which patients would receive the benefits of organ protection by candesartan.

MethodsWe administered candesartan therapy 12 mg daily for 6 months and evaluated whether there was improvement in serum inflammatory parameters high molecular weight adiponectin HMW-ADN, plasminogen activator inhibitor-1 PAI-1, highly sensitive C-reactive protein Hs-CRP, vascular cell adhesion molecule-1 VCAM-1 in serum and urinary-8-hydroxydeoxyguanosine U-8-OHdG. We then analyzed the relationship between the degree of lowering of blood pressure and inflammatory factors and the relationship between pulse pressure and inflammatory factors. Finally, we analyzed predictive factors in patients who received the protective benefit of candesartan.

ResultsAfter 6 months of treatment, significant improvements from baseline values were observed in all patients in HMW-ADN and PAI-1 but not in Hs-CRP, VCAM-1 and U-8-OHdG. Multilinear regression analysis was performed to determine which factors could best predict changes in HMW-ADN and PAI-1. Changes in blood pressure were not significant predictors of changes in metabolic factors in all patients. We found that the group with baseline pulse pressure <60 mmHg had improved HMW-ADN and PAI-1 values compared with the group with baseline pulse pressure ≥ 60 mmHg. These results suggest that pulse pressure at baseline could be predictive of changes in HMW-ADN and PAI-1.

ConclusionsCandesartan improved inflammatory parameters HMW-ADN and PAI-1 in hypertensive patients with type 2 diabetes mellitus of long duration independent of blood pressure changes. Patients with pulse pressure <60 mmHg might receive protective benefits by candesartan.

Trial registrationUMIN000007921

KeywordsCandesartan Angiotensin receptor blockers Type 2 diabetes mellitus Inflammatory parameters Pulse pressure AbbreviationsHMW-ADNHigh molecular weight adiponectin

PAI-1Plasminogen activator inhibitor-1

Hs-CRPHighly sensitive C-reactive protein

VCAM-1Vascular cell adhesion molecule-1

U-8-OHdGUrinary 8-hydroxydeoxyguanosine

ELISAEnzyme-linked immunosorbent assay

PWVPulse pressure and pulse wave velocity

BMIBody mass index

SBPSystolic blood pressure

DPBDiastolic blood pressure

FPGFasting plasma glucose

HbA1cGlycated hemoglobin A1c.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-11-118 contains supplementary material, which is available to authorized users.

Masaya Sakamoto, Hirofumi Suzuki contributed equally to this work.

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Author: Masaya Sakamoto - Hirofumi Suzuki - Takeshi Hayashi - Hiroyuki Iuchi - Tsuyoshi Isaka - Noriko Sakamoto - Yosuke Kayama - K

Source: https://link.springer.com/article/10.1186/1475-2840-11-118







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