title: Changes in biomarkers and 24 hours blood pressure in hypertensive African Americans with the metabolic syndrome: comparison of amlodipine/olmesartan versus hydrochlorothiazide/losartan.
abstract: We evaluated the efficacy of amlodipine and olmesartan (A/O; Azor) versus losartan and hydrochlorothiazide (L/H; Hyzaar), on changes in serum and urine biomarkers of inflammation and oxidation, neutrophil reactive oxygen species generation, and changes in systolic blood pressure (BP), diastolic BP, and heart rate as measured with 24 hours ambulatory BP monitoring in a high-risk, hypertensive African-American population with the metabolic syndrome. Sixty-six African-American subjects with Stage 1 and 2 hypertension and characteristics of the metabolic syndrome were treated in open-label, active comparator fashion for 20 weeks. After 14 weeks of therapy, treatment with A/O had a significant effect on reducing the production of reactive oxygen series, plasminogen activator inhibitor-1, F2 isoprostane, myeloperoxidase, and homeostasis model assessment for insulin resistance while L/H treatment only significantly lowered levels of plasminogen activator inhibitor-1 and homeostasis model assessment for insulin resistance. Treatment with A/O showed a trend of a more immediate and sustained systolic and diastolic BP-lowering, as well as night time BP reduction. In addition to a trend toward lower blood pressure, treatment with A/O in comparison with L/H has superior efficacy in reducing reactive oxygen species generation and production of inflammatory and oxidative biomarkers in a hypertensive African-American population with features of the metabolic syndrome.
authors.affiliation: Atlanta Vascular Research Foundation, Atlanta, GA.
authors.forename: Nadya
authors.initials: N
authors.lastname: Merchant
authors.forename: Syed T
authors.initials: ST
authors.lastname: Rahman
authors.forename: Mushtaq
authors.initials: M
authors.lastname: Ahmad
authors.forename: Janice M
authors.initials: JM
authors.lastname: Parrott
authors.forename: Julie
authors.initials: J
authors.lastname: Johnson
authors.forename: Keith C
authors.initials: KC
authors.lastname: Ferdinand
authors.forename: Bobby V
authors.initials: BV
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D017311:Amlodipine / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D007093:Imidazoles / Q000008:administration & dosage*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000378:metabolism; D008875:Middle Aged; D013777:Tetrazoles / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D007093:Imidazoles; D013777:Tetrazoles; D006852:Hydrochlorothiazide; D017311:Amlodipine; C437965:olmesartan
keywords: African-American; Metabolic syndrome; inflammation; oxidation