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Additive beneficial effects of atorvastatin combined with amlodipine in patients with mild-to-moderate hypertension

2009; Elsevier BV; Volume: 146; Issue: 3 Linguagem: Inglês

10.1016/j.ijcard.2009.07.002

1874-1754

Kwang Kon Koh, Michael J. Quon, Seung Hwan Han, Yonghee Lee, Jeong Beom Park, Soo‐Jin Kim, Yesl Koh, Eak Kyun Shin,

Hormonal Regulation and Hypertension

We hypothesized that atorvastatin combined with amlodipine has additive beneficial vascular and metabolic effects that are superior to monotherapy in patients with hypertension.Forty-two patients were given atorvastatin 20mg/day and placebo, atorvastatin 20mg/day and amlodipine 10mg/day, or amlodipine 10mg/day and placebo during each 2-month treatment period of a randomized, single-blind, placebo-controlled cross-over trial with two 2-month washout periods.Atorvastatin combined with amlodipine or amlodipine alone significantly reduced blood pressure to a greater extent than atorvastatin alone (all P < 0.001 by ANOVA). Atorvastatin combined with amlodipine significantly reduced plasma malondialdehyde and improved flow-mediated dilation to a greater extent than atorvastatin or amlodipine alone (all P < 0.001 by ANOVA). Atorvastatin therapy significantly increased insulin levels (P = 0.004) and decreased plasma adiponectin levels (P = 0.016) and insulin sensitivity (determined by QUICKI; P = 0.026) relative to baseline measurements. Amlodipine therapy significantly decreased insulin levels (P = 0.001) and increased adiponectin levels (P < 0.001) and insulin sensitivity (P = 0.003) relative to baseline measurements. Atorvastatin combined with amlodipine therapy significantly increased adiponectin levels (P < 0.001) and insulin sensitivity (P = 0.034) relative to baseline measurements. Effects of all three therapeutic arms on adiponectin levels and insulin sensitivity were statistically significant (P < 0.001 by ANOVA).Atorvastatin combined with amlodipine therapy improves endothelial function and increases adiponectin levels and insulin sensitivity to a greater extent than monotherapy with either drug in hypertensive patients.