RESUMEN
AIMS: The aim of this work was to evaluate the effects of treatment of hypertension on the autoantibodies to apolipoprotein B-derived peptides (anti-ApoB-D peptide Abs) response, inflammation markers and vascular function. MAIN METHODS: Eighty-eight patients with hypertension (stage 1 or 2) were recruited and advised to receive perindopril (4mg), hydrochlorothiazide (25mg), or indapamide (1.5mg) for 12weeks in a blinded fashion. Office and 24-h ambulatory blood pressure monitoring (24h ABPM), flow-mediated dilatation (FMD), nitrate-induced dilatation (NID), titers of IgG and IgM anti-ApoB-D peptide Abs, hsCRP, and interleukins (IL-8 and IL-10) were evaluated at baseline and 12weeks after therapies. KEY FINDINGS: All treatments reduced office BP, and improved FMD (P<0.05 vs. baseline). The NID was improved only in the perindopril arm (P<0.05 vs. baseline). The 24h-ABPM was reduced with perindopril and hydrochlorothiazide therapies (P<0.05 vs. baseline), but not with indapamide, and this effect was followed by increase in titers of IgM Anti-ApoB-D peptide Abs (P<0.05 vs. baseline), without modifications in titers IgG Anti-ApoB-D peptide Abs and interleukins. Multivariable regression analysis has shown that change in the titers of IgM anti-ApoB-D peptide was associated with the changes in FMD (ß -0.347; P<0.05). SIGNIFICANCE: These findings shed light to a possible modulator effect of the antihypertensive therapy on the natural immunity responses and vascular function.
Asunto(s)
Antihipertensivos/uso terapéutico , Hidroclorotiazida/uso terapéutico , Hipertensión/tratamiento farmacológico , Inmunidad Innata/efectos de los fármacos , Indapamida/uso terapéutico , Perindopril/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antihipertensivos/farmacología , Femenino , Humanos , Hidroclorotiazida/farmacología , Hipertensión/inmunología , Inmunidad Innata/inmunología , Indapamida/farmacología , Masculino , Persona de Mediana Edad , Perindopril/farmacología , Método Simple CiegoRESUMEN
To assess the efficacy and safety of Indapamide, 33 maturity onset diabetics with essential hypertension were treated with Indapamide for 90 days at the single daily dose of 2.5 mg. These patients responded well to treatment: as early as the tenth day, the diastolic blood pressure decreased by 10 mm Hg (p<0.01). At the second month, blood pressure on average was normalized. At the third month, the blood pressure decrease was 16 mm Hg for diastolic and 25.5 mm Hg for systolic. The two-hour post-breakfast blood sugar level was not significantly modified, nor were the other biological parameters monitored: serum creatinine, serum uric acid and serum potassium levels. Indapamide at 2.5 mg per day is effective and safe in hypertensive diabetic patients (AU)