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01.12.2012 | Original investigation | Ausgabe 1/2012 Open Access

Cardiovascular Diabetology 1/2012

Effects of candesartan in hypertensive patients with type 2 diabetes mellitus on inflammatory parameters and their relationship to pulse pressure

Zeitschrift:
Cardiovascular Diabetology > Ausgabe 1/2012
Autoren:
Masaya Sakamoto, Hirofumi Suzuki, Takeshi Hayashi, Hiroyuki Iuchi, Tsuyoshi Isaka, Noriko Sakamoto, Yosuke Kayama, Katsuyoshi Tojo, Michihiro Yoshimura, Kazunori Utsunomiya
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-2840-11-118) contains supplementary material, which is available to authorized users.
Masaya Sakamoto, Hirofumi Suzuki contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

MS and HS conceptualized the research hypothesis and analyses, researched the data, performed all of the statistical analyses and wrote the manuscript. TH, HI, NS and YK reviewed and edited the manuscript. KT and KU assisted in conceptualizing the research question and reviewed and edited the manuscript. All authors read and approved the final manuscript.

Abstract

Background

Angiotensin receptor blockers (ARBs) are reported to provide direct protection to many organs by controlling inflammation and decreasing oxidant stress in patients without arteriosclerosis. This study aimed to evaluate (1) whether an ARB (candesartan) decreases values for inflammatory parameters in hypertensive patients with type 2 diabetes mellitus of long duration accompanied by arteriosclerosis and (2) whether there any predictors of which patients would receive the benefits of organ protection by candesartan.

Methods

We administered candesartan therapy (12 mg daily) for 6 months and evaluated whether there was improvement in serum inflammatory parameters high molecular weight adiponectin (HMW-ADN), plasminogen activator inhibitor-1 (PAI-1), highly sensitive C-reactive protein (Hs-CRP), vascular cell adhesion molecule-1 (VCAM-1) in serum and urinary-8-hydroxydeoxyguanosine (U-8-OHdG). We then analyzed the relationship between the degree of lowering of blood pressure and inflammatory factors and the relationship between pulse pressure and inflammatory factors. Finally, we analyzed predictive factors in patients who received the protective benefit of candesartan.

Results

After 6 months of treatment, significant improvements from baseline values were observed in all patients in HMW-ADN and PAI-1 but not in Hs-CRP, VCAM-1 and U-8-OHdG. Multilinear regression analysis was performed to determine which factors could best predict changes in HMW-ADN and PAI-1. Changes in blood pressure were not significant predictors of changes in metabolic factors in all patients. We found that the group with baseline pulse pressure <60 mmHg had improved HMW-ADN and PAI-1 values compared with the group with baseline pulse pressure ≥ 60 mmHg. These results suggest that pulse pressure at baseline could be predictive of changes in HMW-ADN and PAI-1.

Conclusions

Candesartan improved inflammatory parameters (HMW-ADN and PAI-1) in hypertensive patients with type 2 diabetes mellitus of long duration independent of blood pressure changes. Patients with pulse pressure <60 mmHg might receive protective benefits by candesartan.

Trial registration

UMIN000007921
Zusatzmaterial
Authors’ original file for figure 1
12933_2012_533_MOESM1_ESM.pdf
Authors’ original file for figure 2
12933_2012_533_MOESM2_ESM.pdf
Authors’ original file for figure 3
12933_2012_533_MOESM3_ESM.pdf
Authors’ original file for figure 4
12933_2012_533_MOESM4_ESM.pdf
Authors’ original file for figure 5
12933_2012_533_MOESM5_ESM.pdf
Authors’ original file for figure 6
12933_2012_533_MOESM6_ESM.pdf
Literatur
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