title: Calcium channel blocker effect on insulin resistance and inflammatory markers in essential hypertension patients.
abstract: OBJECTIVE
  Insulin resistance, inflammation and oxidative stress (OS), are among the mechanisms that have been implicated in pathogenesis of essential hypertension (EH). Peripheral polymorphonuclear leukocytes (PMNLs) are primed in EH patients, releasing uncontrolled superoxide anion contributing to OS in these patients. PMNL priming correlates with insulin resistance and with PMNL intracellular calcium ([Ca2+]i). Recent studies have attributed to the anti-hypertensive drug lercanidipine, a third generation calcium-channel blocker, and additional anti-ischemic and anti-oxidative characteristics. Aim of the study was to evaluate the possible non-traditional effect of two months of lercanidipine treatment on insulin resistance and on PMNL-related inflammation in EH patients.
  
  
  METHODS
  Non-smoking EH patients with untreated mild to moderate high blood pressure (BP) were included. Low-graded inflammation was reflected by WBC and PMNL counts and by PMNL apoptosis. Systemic inflammation was measured by plasma fibrinogen, CRP and albumin levels. Fasting serum insulin levels served as a marker of insulin resistance.
  
  
  RESULTS
  Two months of lercanidipine treatment showed significant decrease in BP, in WBC and PMNL counts, in PMNL apoptosis, in CRP and serum insulin levels and significant increase in serum albumin levels. Rates of superoxide release from PMNLs, WBC and PMNL counts and insulin levels positively correlated with mean arterial blood pressure values.
  
  
  CONCLUSIONS
  We imply that use of this CCB lercanidipine can be favored in EH patients due to its combined anti-PMNL priming and anti-inflammatory effects, in addition to its anti-hypertensive characteristics.
authors: Department of Internal Medicine B, Ziv Medical Center, Safed, Israel. raymond.f@ziv.health.gov
authors: R
authors: R
authors: Farah
authors: R
authors: R
authors: Khamisy-Farah
authors: R
authors: R
authors: Shurtz-Swirski
mesh_terms: D000328:Adult; D000368:Aged; D002121:Calcium Channel Blockers / Q000494:pharmacology* / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy*; D018836:Inflammation Mediators / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D018836:Inflammation Mediators; C060343:lercanidipine