Diabetic patients with essential hypertension treated with amlodipine: blood pressure and arterial stiffness effects of canagliflozin or perindopril

被引:38
|
作者
Ramirez, Agustin J. [1 ,2 ]
Sanchez, Maria J. [1 ]
Sanchez, Ramiro A. [1 ,2 ]
机构
[1] Fdn Study Hypertens & Cardiovasc Risk, Buenos Aires, DF, Argentina
[2] Favaloro Fdn, Univ Hosp, Hypertens & Metabol Unit, Buenos Aires, DF, Argentina
关键词
arterial hypertension; canaglifozin; central blood pressure; pulse wave velocity; CARDIOVASCULAR EVENTS; SGLT2; INHIBITORS; MELLITUS; MECHANISMS; COTRANSPORTERS; EMPAGLIFLOZIN; RAMIPRIL; OUTCOMES; MARKERS; IMPACT;
D O I
10.1097/HJH.0000000000001907
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Introduction: Hypertension control reduces cardiovascular and renal risks in type 2 diabetes. Sodium-glucose cotransporter-2 inhibitors prevent renal glucose reabsorption and decrease glucose plasma levels, blood pressure (BP) and weight reduction. Treatment of hypertension and sodium-glucose cotransporter-2 are able to improve arterial stiffness. Aims: To evaluate, in patients with type 2 diabetes and hypertension, the effects of 6 months treatment with canagliflozin, or perindopril, an angiotensin converting enzyme inhibitor, on central BP and carotid-femoral pulse wave velocity (cfPWV). Methods: Thirty type 2 diabetic patients with hypertension taking amlodipine, 10 mg daily, and metformin, 750-2000 mg daily, were randomized and a third medication was added: canagliflozin, 300 mg daily (n = 15, nine women, mean age: 63 +/- 8 years), or perindopril, 10 mg daily (n = 15, five women, mean age 59 +/- 4 years), for 6 months. Ambulatory BP monitoring was assessed at baseline and after 3 and 6 months of treatment, whereas cfPWV was measured before and after 6 months of treatment. Plasma fasting glucose, glycated hemoglobin, creatinine, plasma and urinary sodium and potassium were also measured. Results: Both treatments significantly reduced BP and cfPWV. Only canagliflozin maintained the PWV action after adjusting for BP values and reduced glycemia, glycated hemoglobin and 24 h urinary sodium. Other security laboratory parameters, including gluthamic oxaloacetic transaminase, gluthamic piruvic transaminase; and bilirubin failed to show any change. Conclusion: Canagliflozin reduced BP and improve arterial stiffness, independently of the BP effect. These two conditions could explain the cardiovascular protection observed with canagliflozin compared with perindopril.
引用
收藏
页码:636 / 642
页数:7
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