Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Effect of Lacidipine on Blood Pressure and Endothelial Function in Mild-to-Moderate Essential Hypertension Patients With Diabetes in Korea

  • Kim, Dae-Hee (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Oh, Il-Young (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Lee, Hae-Young (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim, Yong-Jin (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim, Hyo-Soo (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim, Cheol-Ho (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Oh, Byung-Hee (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim, Kwon-Sam (Department of Internal Medicine, Kyung Hee University College of Medicine) ;
  • Kim, Doo-Il (Department of Internal Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Kim, Young-Dae (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Ryu, Kyu-Hyung (Department of Internal Medicine, Konkuk University College of Medicine) ;
  • Park, Si-Hoon (Department of Internal Medicine, Ewha Womans University College of Medicine, Mokdong Hospital) ;
  • Baek, Sang-Hong (Department of Internal Medicine, The Catholic University College of Medicine, Seoul St. Mary's Hospital) ;
  • Shin, Dong-Gu (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Shim, Wan-Joo (Department of Internal Medicine, Korea University College of Medicine, Anam Hospital) ;
  • Ahn, Tae-Hoon (Department of Internal Medicine, Gachon University Gil Hospital) ;
  • Oh, Seok-Kyu (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Lee, Seung-Hwan (Department of Internal Medicine, Yonsei University Wonju Christian Hospital) ;
  • Lee, Sung-Yun (Department of Internal Medicine, Inje University College of Medicine, IIsan Paik Hospital) ;
  • Jeong, Myung-Ho (Department of Internal Medicine, Chonnam National University College of Medicine) ;
  • Chung, Wook-Sung (Department of Internal Medicine, The Catholic University College of Medicine, Seoul St. Mary's Hospital) ;
  • Jeong, Jun-Young (Department of Internal Medicine, Eulji University College of Medicine) ;
  • Choi, So-Yeon ;
  • Choi, Si-Wan (Department of Internal Medicine, Chungnam National University College of Medicine) ;
  • Hyon, Min-Su (Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • Received : 2010.03.03
  • Accepted : 2010.05.27
  • Published : 2010.12.30
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Abstract

Background and Objectives: The aim of this study was to evaluate the efficacy of lacidipine in reducing blood pressure (BP) and to determine its effect on endothelial function in mild-to-moderate hypertensive patients with type 2 diabetes mellitus (DM). Subjects and Methods: This was a prospective, multicenter, open-label, single-arm study, enrolling 290 patients with mild-to-moderate hypertension and type 2 DM. Patients were initially treated with 2 mg lacidipine orally once daily for 4 weeks, which was then increased as necessary every 4 weeks to a maximal dose of 6 mg daily. The primary endpoint was the mean change in systolic blood pressure (SBP) from baseline after 12 weeks of treatment. Secondary endpoints included mean changes in diastolic blood pressure (DBP), flow-mediated vasodilatation (FMD), and serum concentrations of biochemical markers such as high-sensitivity C-reactive protein (hs-CRP), monocyte chemo-attractant protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), and plasminogen activator inhibitor-1 (PAI-1). Results: Lacidipine treatment significantly reduced SBP by -13.4${\pm}$13.0 mmHg (p<0.001) and DBP by -6.2${\pm}$9.3 mmHg (p<0.001). Lacidipine treatment did not improve endothelial-dependent vasodilatation, despite significantly improved nitroglycerin-induced, endothelial-independent vasodilatation. MCP-1 levels significantly decreased from 283.66${\pm}$110.08 pg/mL to 257.83${\pm}$100.23 pg/mL (p<0.001); whereas there were no significant changes in the levels of hs-CRP, MMP-9, or PAI-1. Conclusion: Twelve weeks of treatment with lacidipine was effective and well tolerated in mild-to-moderate hypertensive patients with type 2 DM. In spite of inducing a significant reduction in MCP-1 levels, lacidipine did not improve endothelial function.

Keywords

References

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