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Distinct effects of fixed combinations of valsartan with either amlodipine or hydrochlorothiazide on lipoprotein subfraction profile in patients with hypertension

Journal of Human Hypertension volume 27, pages 44–50 (2013)Cite this article

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Abstract

The effect of antihypertensive drugs on lipoprotein subfraction profile is still under investigation. In this study the effects of fixed combination of valsartan with either amlodipine (V–A) or hydrochlorothiazide (V–H) on low-density-lipoprotein (LDL) and high-density-lipoprotein (HDL) subfraction profile of patients with stage 2 or 3 hypertension were assessed. A total of 60 drug-naive patients were randomized to either V–A (160/5 mg, n=30) or V–H (160/12.5 mg, n=30). At baseline as well as 16 weeks post-treatment analysis of the LDL and HDL subfraction profile was conducted by using LDL Lipoprint System. Both V–A and V–H effectively reduced blood pressure (BP) to similar levels. An increase in the cholesterol concentration of small-dense LDL subfractions (by 18.2%, P<0.05) was observed in the V–H group, whereas this parameter remained unchanged in the V–A group. Therefore, mean LDL particle size was decreased in the V–H group (from 267±5 to 266±5Å, P<0.05). HDL-Cholesterol (HDL-C) levels were reduced by 4.7% (P<0.05) in the V–H group, mirrored by a reduction in the cholesterol mass of small and intermediate HDL particles. In conclusion, despite similar reductions in BP, V–H combination may adversely affect serum lipids as well as LDL and HDL subfraction profile as compared with V–A.

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Acknowledgements

This study was conducted independently; no company or institution supported it financially. Some authors (that is, HJ Milionis, AD Tselepis and MS Elisaf) have given talks, attended conferences and participated in trials sponsored by pharmaceutical companies (for example, Pfizer, Novartis, Astra Zeneca and Merck, Sharp and Dohme). The pharmaceutical industry had no role in the design, conduct, analysis or publication of the study.

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Authors and Affiliations

  1. Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece

    L G Christogiannis, M S Kostapanos, H J Milionis & M S Elisaf

  2. Department of Chemistry, Laboratory of Biochemistry, University of Ioannina, Ioannina, Greece

    C C Tellis & A D Tselepis

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  1. L G Christogiannis
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Correspondence to M S Elisaf.

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Christogiannis, L., Kostapanos, M., Tellis, C. et al. Distinct effects of fixed combinations of valsartan with either amlodipine or hydrochlorothiazide on lipoprotein subfraction profile in patients with hypertension. J Hum Hypertens 27, 44–50 (2013). https://doi.org/10.1038/jhh.2011.108

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