Endothelial dysfunction is a target for combination antihypertensive therapy in hypertensive patients with type 2 diabetes mellitus

Aim. To evaluate the impact of combination antihypertensive therapy with lisinopril + amlodipine (Еkvator) on endothelial dysfunction in patients with hypertension and concurrent type 2 diabetes mellitus (T2DM). Subjects and methods. The trial enrolled 30 patients aged 40 to 65 years with Stages II-III hypertension concurrent with T2DM. All the patients received combination antihypertensive therapy with lisinopril + amlodipine (ekvator) for 12 weeks. Endothelial function was studied from serum and urinary NO and endothelin-1 concentrations and occlusion test results. 24-hour blood pressure (BP) monitoring and echocardiography were performed; arterial elastic properties and renal function were investigated. Results. After 12-week therapy, 93.3% of the patients achieved BP goals. Endothelial function was improved in hypertensive patients with T2DM: there were increases in both serum and urinary NO production (by 53.5 and 57.1%, respectively) and decreases in serum and urinary endothelin-1 secretion (by 27.7 and 69.6%, respectively). The number of patients with normal microcirculation increased from 13.3 to 73.3% (p<0.001). There was significant improvement in 24-hour AP monitoring readings and reductions in the left ventricular mass index by 10.7% and microalbuminuria by 27.7%; the number of patients with increased pulse wave velocity along the elastic arteries declined by 30%. Conclusion. Twelve-week treatment with the combined antihypertensive medication ekvator is highly effective and safe for recovering endothelial function and improving the state of target organs in hypertensive patients with T2DM.

endothelial dysfunction, combination antihypertensive therapy, hypertension, type 2 diabetes mellitus