Effect of Lacidipine on Blood Pressure and Endothelial Function in Mild-to-Moderate Essential Hypertension Patients With Diabetes in Korea.
OBJECTIVE
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).


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±13.0 mmHg (p<0.001) and DBP by -6.2±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±110.08 pg/mL to 257.83±100.23 pg/mL (p<0.001); whereas there were no significant changes in the levels of hs-CRP, MMP-9, or PAI-1.


CONCLUSIONS
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.
Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
Dae-Hee
DH
Kim
Il-Young
IY
Oh
Hae-Young
HY
Lee
Yong-Jin
YJ
Kim
Hyo-Soo
HS
Kim
Cheol-Ho
CH
Kim
Byung-Hee
BH
Oh
Kwon-Sam
KS
Kim
Doo-Il
DI
Kim
Young-Dae
YD
Kim
Kyu-Hyung
KH
Ryu
Si-Hoon
SH
Park
Sang-Hong
SH
Baek
Dong-Gu
DG
Shin
Wan Joo
WJ
Shim
Tae-Hoon
TH
Ahn
Seok-Kyu
SK
Oh
Seung-Hwan
SH
Lee
Sung-Yun
SY
Lee
Myung-Ho
MH
Jeong
Wook-Sung
WS
Chung
Jun-Young
JY
Jeong
So-Yeon
SY
Choi
Si-Wan
SW
Choi
Min-Su
MS
Hyon
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