Treatment with amlodipine and atorvastatin has additive effect on blood and plaque inflammation in hypertensive patients with carotid atherosclerosis.
Since previous studies have reported a beneficial effect of amlodipine and atorvastatin treatment in experimental atherosclerosis, we aimed to investigate the effect of the combination of both drugs on blood and plaque inflammation in patients with carotid stenosis. For that purpose, twenty six hypertensive patients undergoing carotid endarterectomy were randomized to receive either atorvastatin 20 mg/day alone (ATV, n=12) or in combination with amlodipine 20 mg/day (ATV+AML, n=14) before scheduled carotid endarterectomy. At the end of follow-up (4-6 weeks), there was a significant decrease in total and LDL-cholesterol levels, but not in blood pressure levels. In contrast, decreased MCP-1 plasma levels, NF-kappaB activation (EMSA) and MCP-1 mRNA expression (quantitative PCR) was only observed in blood from ATV+AML treated-patients. Moreover, carotid atherosclerotic plaques from ATV+AML group demonstrated a significant reduction in macrophage infiltration in relation to ATV group (immunohistochemistry). Our results suggest that combined treatment with atorvastatin and amlodipine decreases inflammatory status of atherosclerotic patients more than atorvastatin treatment alone, suggesting that co-administration of both drugs could have beneficial additive effects.
Martín-Ventura
José L
JL
The Renal and Vascular Research Lab, Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain.
Muñoz-Garcia
Begoña
B
Blanco-Colio
Luis M
LM
Martín-Conejero
Antonio
A
Madrigal-Matute
Julio
J
Vega
Melina
M
Ortega
Luis
L
Serrano
Javier
J
Egido
Jesús
J
D000368:Aged; D017311:Amlodipine / Q000494:pharmacology / Q000627:therapeutic use*; D000924:Anticholesteremic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000069059:Atorvastatin; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D002340:Carotid Artery Diseases / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D016893:Carotid Stenosis / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D018932:Chemokine CCL2 / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004357:Drug Synergism; D005260:Female; D006538:Heptanoic Acids / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism; D011758:Pyrroles / Q000494:pharmacology / Q000627:therapeutic use*; D012333:RNA, Messenger / Q000378:metabolism
D000924:Anticholesteremic Agents; C111835:CCL2 protein, human; D002121:Calcium Channel Blockers; D018932:Chemokine CCL2; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D016328:NF-kappa B; D011758:Pyrroles; D012333:RNA, Messenger; D017311:Amlodipine; D000069059:Atorvastatin