Effects of combined statin and ACE inhibitor therapy on endothelial function and blood pressure in essential hypertension - a randomised double-blind, placebo controlled crossover study

Background: The aim of this study was to compare the influence of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors on endothelial function and blood pressure in patients with essential hypertension on long-term angiotensin-converting enzyme inhibitor therapy. Method: The study was designed...

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Published in:Journal of the renin-angiotensin-aldosterone system 2019-07, Vol.20 (3), p.1470320319868890-1470320319868890
Main Authors: Ruszkowski, Piotr, Masajtis-Zagajewska, Anna, Nowicki, Michał
Format: Article
Language:English
Subjects:
ACE inhibitors
Angiotensin-Converting Enzyme Inhibitors - pharmacology
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Biomarkers - blood
Blood pressure
Blood Pressure - drug effects
Double-blind studies
Drug Therapy, Combination
Endothelium, Vascular - drug effects
Endothelium, Vascular - physiopathology
Enzymes
Essential Hypertension - blood
Essential Hypertension - drug therapy
Essential Hypertension - physiopathology
Female
Fluvastatin - pharmacology
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hypertension
Male
Middle Aged
Original
Placebos
Proteins
Statins
Vascular endothelial growth factor
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creator Ruszkowski, Piotr
Masajtis-Zagajewska, Anna
Nowicki, Michał
description Background: The aim of this study was to compare the influence of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors on endothelial function and blood pressure in patients with essential hypertension on long-term angiotensin-converting enzyme inhibitor therapy. Method: The study was designed as a prospective, double-blind, randomised, placebo controlled, crossover clinical trial. Twenty patients with essential hypertension were treated with an angiotensin-converting enzyme inhibitor; the control group included 10 healthy subjects. Hypertensive patients received in random order 80 mg of fluvastatin daily or placebo for 6 weeks. The following parameters were assessed at baseline and after each treatment period: serum lipids, flow-mediated vasodilation, activity of von Willebrand factor, concentration of vascular endothelial growth factor, C-reactive protein and 24-hour blood pressure profile. Results: Hypertensive patients did not differ from healthy subjects with respect to age, body mass and biochemical parameters, with the exception of C-reactive protein, which was higher in hypertensive patients (P=0.02). After statin therapy, low-density lipoprotein cholesterol (P
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Method: The study was designed as a prospective, double-blind, randomised, placebo controlled, crossover clinical trial. Twenty patients with essential hypertension were treated with an angiotensin-converting enzyme inhibitor; the control group included 10 healthy subjects. Hypertensive patients received in random order 80 mg of fluvastatin daily or placebo for 6 weeks. The following parameters were assessed at baseline and after each treatment period: serum lipids, flow-mediated vasodilation, activity of von Willebrand factor, concentration of vascular endothelial growth factor, C-reactive protein and 24-hour blood pressure profile. Results: Hypertensive patients did not differ from healthy subjects with respect to age, body mass and biochemical parameters, with the exception of C-reactive protein, which was higher in hypertensive patients (P=0.02). After statin therapy, low-density lipoprotein cholesterol (P&lt;0.0001), C-reactive protein (P=0.03), von Willebrand factor (P=0.03) and vascular endothelial growth factor (P&lt;0.01) decreased and flow-mediated vasodilation improved (P&lt;0.001). Statins had no significant effect on blood pressure. Conclusions: Statins added to angiotensin-converting enzyme inhibitors may improve endothelial function and ameliorate inflammation independently of blood pressure.</description><identifier>ISSN: 1470-3203</identifier><identifier>EISSN: 1752-8976</identifier><identifier>DOI: 10.1177/1470320319868890</identifier><identifier>PMID: 31486700</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>ACE inhibitors ; Angiotensin-Converting Enzyme Inhibitors - pharmacology ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Biomarkers - blood ; Blood pressure ; Blood Pressure - drug effects ; Double-blind studies ; Drug Therapy, Combination ; Endothelium, Vascular - drug effects ; Endothelium, Vascular - physiopathology ; Enzymes ; Essential Hypertension - blood ; Essential Hypertension - drug therapy ; Essential Hypertension - physiopathology ; Female ; Fluvastatin - pharmacology ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Hypertension ; Male ; Middle Aged ; Original ; Placebos ; Proteins ; Statins ; Vascular endothelial growth factor</subject><ispartof>Journal of the renin-angiotensin-aldosterone system, 2019-07, Vol.20 (3), p.1470320319868890-1470320319868890</ispartof><rights>The Author(s) 2019</rights><rights>The Author(s) 2019. This work is licensed under the Creative Commons Attribution – Non-Commercial License http://www.creativecommons.org/licenses/by-nc/4.0/ (the “License”). 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Method: The study was designed as a prospective, double-blind, randomised, placebo controlled, crossover clinical trial. Twenty patients with essential hypertension were treated with an angiotensin-converting enzyme inhibitor; the control group included 10 healthy subjects. Hypertensive patients received in random order 80 mg of fluvastatin daily or placebo for 6 weeks. The following parameters were assessed at baseline and after each treatment period: serum lipids, flow-mediated vasodilation, activity of von Willebrand factor, concentration of vascular endothelial growth factor, C-reactive protein and 24-hour blood pressure profile. Results: Hypertensive patients did not differ from healthy subjects with respect to age, body mass and biochemical parameters, with the exception of C-reactive protein, which was higher in hypertensive patients (P=0.02). After statin therapy, low-density lipoprotein cholesterol (P&lt;0.0001), C-reactive protein (P=0.03), von Willebrand factor (P=0.03) and vascular endothelial growth factor (P&lt;0.01) decreased and flow-mediated vasodilation improved (P&lt;0.001). Statins had no significant effect on blood pressure. 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Method: The study was designed as a prospective, double-blind, randomised, placebo controlled, crossover clinical trial. Twenty patients with essential hypertension were treated with an angiotensin-converting enzyme inhibitor; the control group included 10 healthy subjects. Hypertensive patients received in random order 80 mg of fluvastatin daily or placebo for 6 weeks. The following parameters were assessed at baseline and after each treatment period: serum lipids, flow-mediated vasodilation, activity of von Willebrand factor, concentration of vascular endothelial growth factor, C-reactive protein and 24-hour blood pressure profile. Results: Hypertensive patients did not differ from healthy subjects with respect to age, body mass and biochemical parameters, with the exception of C-reactive protein, which was higher in hypertensive patients (P=0.02). After statin therapy, low-density lipoprotein cholesterol (P&lt;0.0001), C-reactive protein (P=0.03), von Willebrand factor (P=0.03) and vascular endothelial growth factor (P&lt;0.01) decreased and flow-mediated vasodilation improved (P&lt;0.001). Statins had no significant effect on blood pressure. Conclusions: Statins added to angiotensin-converting enzyme inhibitors may improve endothelial function and ameliorate inflammation independently of blood pressure.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>31486700</pmid><doi>10.1177/1470320319868890</doi><orcidid>https://orcid.org/0000-0001-8860-2089</orcidid><oa>free_for_read</oa></addata></record>
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ispartof Journal of the renin-angiotensin-aldosterone system, 2019-07, Vol.20 (3), p.1470320319868890-1470320319868890
issn 1470-3203
1752-8976
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source Open Access: PubMed Central; ProQuest - Publicly Available Content Database
subjects ACE inhibitors
Angiotensin-Converting Enzyme Inhibitors - pharmacology
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Biomarkers - blood
Blood pressure
Blood Pressure - drug effects
Double-blind studies
Drug Therapy, Combination
Endothelium, Vascular - drug effects
Endothelium, Vascular - physiopathology
Enzymes
Essential Hypertension - blood
Essential Hypertension - drug therapy
Essential Hypertension - physiopathology
Female
Fluvastatin - pharmacology
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hypertension
Male
Middle Aged
Original
Placebos
Proteins
Statins
Vascular endothelial growth factor
title Effects of combined statin and ACE inhibitor therapy on endothelial function and blood pressure in essential hypertension - a randomised double-blind, placebo controlled crossover study
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