Effects of AT1 receptor and beta1 receptor blocking on blood pressure, peripheral hemodynamic and lipid profile in statin-treated hypertensive hypercholesterolemic patients.
Recent evidences suggest a relationship between angiotensin 1 (AT1) receptor gene expression and low density lipoprotein cholesterol (LDL-C) plasma level. We enrolled 16 untreated hypertensive hypercholesterolemic patients (57.4 +/- 7 years old) in a randomized, single-blind, cross-over design. All the patients were allocated to treatment with simvastatin 20 mg/day for 2 weeks, then randomly assigned to telmisartan (40-80 mg/day) or bisoprolol (5-10 mg/day). After 4 weeks the antihypertensive drugs have been withdrawn for a wash-out period of 2 weeks when they were treated with simvastatin alone, then they have been allocated to the alternative antihypertensive treatment for four additional weeks. We measured: systolic (SBP) and diastolic BP (DBP), 24-h mean BP (MBP), Baseline and post-ischemia forearm blood flow (FBF) and vascular resistance (FVR), and Lipid profile. After 2 weeks of treatment with Simvastatin, baseline and post-ischemic FBF increased (both P < 0.05), while baseline and post-ischemic FVR decreased (both P < 0.05). Standing DBP and MBP were reduced more after treatment with telmisartan than with bisoprolol (P < 0.05). Basal and post-ischemic FBF were significantly increased (P < 0.05 and P < 0.005, respectively) and basal and post-ischemic FVR significantly decreased (both P < 0.005) only after treatment with telmisartan, as well as plasma triglycerides (TG) (P < 0.05). From this preliminary study carried out on hypercholesterolemic hypertensive patients it appears that the association of telmisartan and simvastatin (but not of bisoprolol and simvastatin) could exert positive effects on a large quantity of vascular functionality parameters, just after a short treatment.
Cicero
Arrigo F G
AF
Hypertension Research Unit, Sant'Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy.
Veronesi
Maddalena
M
Prandin
Maria Grazia
MG
Di Gregori
Valentina
V
Ambrosioni
Ettore
E
Borghi
Claudio
C
D000293:Adolescent; D058671:Adrenergic beta-1 Receptor Antagonists; D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001565:Benzoates / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D017298:Bisoprolol / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D018592:Cross-Over Studies; D004334:Drug Administration Schedule; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D044140:Receptor, Angiotensin, Type 1 / Q000378:metabolism*; D019821:Simvastatin / Q000008:administration & dosage / Q000627:therapeutic use*; D000077333:Telmisartan; D016896:Treatment Outcome; D055815:Young Adult
D058671:Adrenergic beta-1 Receptor Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001565:Benzoates; D008055:Lipids; D044140:Receptor, Angiotensin, Type 1; D019821:Simvastatin; D000077333:Telmisartan; D017298:Bisoprolol