Additive Beneficial Effects of Losartan Combined With Simvastatin in the Treatment of Hypercholesterolemic, Hypertensive Patients

Ovid Technologies (Wolters Kluwer Health) - Tập 110 Số 24 - Trang 3687-3692 - 2004
Kwang Kon Koh1, Michael J. Quon2, Seung Hwan Han3, Wook‐Jin Chung4, Jeong Yeal Ahn5, Yiel‐Hea Seo6, Moon Ho Kang7, Tae Hoon Ahn8, In Suck Choi9, Eak Kyun Shin10
1Kwang Kon Koh From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.
2Michael J. Quon From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.
3Seung Hwan Han From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.
4Wook-Jin Chung From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.
5Jeong Yeal Ahn From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.
6Yiel-Hea Seo From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.
7Moon Ho Kang From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.
8Tae Hoon Ahn From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.
9In Suck Choi From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.
10Eak Kyun Shin From Cardiology (K.K.K., S.H.H., W.-J.C., T.H.A., I.S.C., E.K.S.), Laboratory Medicine (J.Y.A., Y.-H.S.), and Endocrinology (M.H.K.), Gachon Medical School, Incheon, Korea, and Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH (M.J.Q.), Bethesda, Md.

Tóm tắt

Background— Biological mechanisms underlying statin and angiotensin II type 1 receptor blocker therapies differ. Therefore, we compared vascular and metabolic responses to these therapies either alone or in combination in hypercholesterolemic, hypertensive patients. Methods and Results— This was a randomized, double-blind, placebo-controlled crossover trial with 3 treatment arms (each 2 months) and 2 washout periods (each 2 months). Forty-seven hypertensive, hypercholesterolemic patients were given simvastatin 20 mg and placebo, simvastatin 20 mg and losartan 100 mg, or losartan 100 mg and placebo daily during each 2-month treatment period. Losartan alone or combined therapy significantly reduced blood pressure compared with simvastatin alone. Compared with losartan alone, simvastatin alone or combined therapy significantly changed lipoproteins. All 3 treatment arms significantly improved flow-mediated dilator response to hyperemia and decreased plasma malondialdehyde and monocyte chemoattractant protein-1 levels relative to baseline measurements. However, these parameters were changed to a greater extent with combined therapy compared with simvastatin or losartan alone (both P <0.001 and P =0.030 for monocyte chemoattractant protein-1 by ANOVA). Combined therapy or losartan alone significantly increased plasma adiponectin levels and insulin sensitivity (determined by QUICKI) relative to baseline measurements. These changes were significantly greater than in the group treated with simvastatin alone ( P <0.001 for adiponectin, P =0.029 for QUICKI by ANOVA). Conclusions— Simvastatin combined with losartan improves endothelial function and reduces inflammatory markers to a greater extent than monotherapy with either drug in hypercholesterolemic, hypertensive patients.

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10.1161/circ.103.15.1961

10.1210/jcem.85.7.6661

10.1161/01.atv.0000030997.02059.bb

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10.1152/ajpheart.1997.272.6.H2701

10.1161/circ.100.21.2131

10.1161/circ.104.5.576

10.1161/res.85.1.23

10.1161/01.cir.0000061916.95736.e5

10.1161/01.hyp.0000024348.87637.6f

10.1161/01.hyp.0000036448.44066.53

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Ovid Technologies (Wolters Kluwer Health)

Tập 110 Số 24

3687-3692

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