Рациональная фармакотерапия в кардиологии (Nov 2016)
Correction of Endothelial Dysfunction in Patients with Essential Hypertension when Using a Combination of Olmesartan/Lercanidipine and Zofenopril/Lercanidipine
Abstract
Aim. To study the effect of olmesartan/lercanidipine combination and zofenopril/lercanidipine combination on the level of soluble platelet-endothelial cell adhesion molecule of the first type (sPECAM-1) in plasma in patients with essential hypertension (HT) stage II-III.Material and methods. We examined 44 people: 16 healthy volunteers (control group) and 28 patients with essential HT aged 40 to 71 years; among them 8 patients with HT II stage and 20 patients with HT III stage. Part of HP patients (subgroup 1A, n=6) received a combination of olmesartan 10- 40 mg/day + lercanidipine 5-10 mg/day; another part of HP patients (subgroup 1B, n=11) received a combination of zofenopril 7.5-30 mg/day + lercanidipine 5-10 mg/day. The examination at baseline and after 7 months included the measurement of office systolic (SBP) and diastolic (DBP) blood pressure, determination of sPECAM-1 levels in blood plasma by quantitative solid-phase enzyme immunoassay, electrocardiography, transthoracic echocardiography, complete clinical blood test, general urine analysis, biochemical blood test with lipid profile.Results. In patients with HT stage III the level of sPECAM-1 was significantly higher than in the control group (259.10 [145.36; 329.33] vs 133.18 [73.07; 170.99] pg/ml, respectively; p<0.05). These patients had also significantly higher level of low density lipoproteins cholesterol and triglycerides compared with the control group. After 7 months of therapy a significant reduction in office SBP/DBP levels was found both in 1A and in 1B subgroups (19/7 and 37/8 mmHg, respectively). Reduction in sPECAM-1 levels was also observed in both subgroups of treated patients; however, it was significant only in the 1A subgroup (p<0.05).Conclusion. sPECAM-1 level is increased in patients with essential HT stage III. Despite the reduction in office SBP and DBP in both treated groups, only the subgroup of olmesartan + lercanidipine demonstrated significant decrease in sPECAM-1 level (p<0.05). Thus, olmesartan + lercanidipine combination has more significant effect on endothelial function than zofenopril + lercanidipine combination.
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