title: Effects of enalapril/lercanidipine combination on some emerging biomarkers in cardiovascular risk stratification in hypertensive patients.
abstract: OBJECTIVE
  There is considerable interest in pharmacogenetic and molecular biomarkers. Our aim was to evaluate the effects of enalapril/lercanidipine combination on some emerging biomarkers for cardiovascular risk stratification of hypertensive patients, such as lipoprotein(a) [Lp(a)], soluble advanced glycation end products (sRAGE), soluble CD40 ligand (sCD40L) and serum myeloperoxidase (MPO).
  
  
  METHODS
  Three hundred and forty-five patients were enrolled in this randomized, double-blind, clinical trial: 120 hypertensive patients were randomized to enalapril 20 mg, 110 to lercanidipine 10 mg and 115 to enalapril/lercanidipine 20/10 mg fixed combination. We measures the following markers at baseline and after 6, 12, 18 and 24 months: blood pressure, fasting plasma glucose (FPG), lipid profile, Lp(a), sRAGE, sCD40L and MPO.
  
  
  RESULTS
  There was a decrease in blood pressure in all groups compared with baseline, even if, as expected, enalapril/lercanidipine combination was more effective in reducing blood pressure compared with the monotherapies. No variations in lipid profile or FPG were recorded in any of the groups. Lercanidipine, but not enalapril, improved Lp(a) levels compared with baseline. The combination enalapril/lercanidipine improved it more than the single therapies. All treatments increased sRAGE levels, and decreased sCD40L and MPO, with a better effect seen with the enalapril/lercanidipine combination compared with single monotherapies.
  
  
  CONCLUSIONS
  The combination enalapril/lercanidipine seems to be better than the single monotherapies in reducing not only blood pressure, but also the levels of some emerging biomarkers, potentially useful for cardiovascular risk stratification of hypertensive patients.
authors.affiliation: Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy; Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research, University of Pavia, Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Derosa
authors.forename: A
authors.initials: A
authors.lastname: Bonaventura
authors.forename: D
authors.initials: D
authors.lastname: Romano
authors.forename: L
authors.initials: L
authors.lastname: Bianchi
authors.forename: E
authors.initials: E
authors.lastname: Fogari
authors.forename: A
authors.initials: A
authors.lastname: D'Angelo
authors.forename: P
authors.initials: P
authors.lastname: Maffioli
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers; D001786:Blood Glucose; D001794:Blood Pressure; D023201:CD40 Ligand / Q000097:blood; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy; D004095:Dihydropyridines / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D004656:Enalapril / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000097:blood; D012307:Risk Factors
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D001786:Blood Glucose; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D004338:Drug Combinations; D008055:Lipids; D023201:CD40 Ligand; D004656:Enalapril; D009195:Peroxidase; C060343:lercanidipine
keywords: enalapril; hypertension; lercanidipine; risk factors