Volume 1 Issue 1

Research Article: Effects of Amlodipine plus Atorvastatin on Arterial Function in Essential Hypertension: A Randomized Controlled Study

Yan Yang, Ya-qiong Wang, Zhe Hu, Yu-jing Shen and Ping-jin Gao*

We aimed to investigate the potential effects of fix-dose atorvastatin plus amlodipine treatment and amlodipine alone treatment for 24 weeks on blood pressure, arterial stiffness and endothelial function in patients with hypertension and hypercholesterolemia. In a single-blinded, randomized, placebo-controlled and parallel design, 60 hypertensive and hypercholesterolemic patients were allocated to receive atorvastatin 10 mg/day plus amlodipine 5 mg/day or amlodipine 5 mg/day for 24 weeks. Central blood pressure was reduced significantly greater in atorvastatin plus amlodipine group than in amlodipine group after 12 and 24 weeks' treatment. Both amlodipine and atorvastatin plus amlodipine therapy significantly improved Flow-Mediated Dilation (FMD) compared to baseline (p < 0.01), the effect of atorvastatin plus amlodipine therapy was even greater after 24 weeks(p < 0.05). Atorvastatin plus amlodipine therapy significantly decreased Heart Rate-Adjusted Augmentation Index (AIx@HR75), carotid-femoral and brachial-ankle Pulse Wave Velocity (PWV) when compared with baseline in both 12 weeks and 24 weeks' administration, while amlodipine therapy not. FMD improvement was independently correlated with change in TC (β = -0.416, P = 0.004), while arterial stiffness improvement assessed with AIx@HR75 and baPWV, was correlated with change in central SBP (β = 0.772, P < 0.001, and β = 0.420, P = 0.003, respectively) in multivariate linear stepwise model. Fixed-dose amlodipine and atorvastatin treatment for 24 weeks reduced central BP and arterial stiffness, improved endothelial function greater than amlodipine therapy. Our findings suggested decrease in TC was the independent protective factor for endothelial function improvement and decrease in central SBP was the independent protective factor for arterial stiffness reduction during the follow-up period.

Cite this Article: Yang Y, Wang YQ, Hu Z, Shen Yj, Gao Pj. Effects of Amlodipine plus Atorvastatin on Arterial Function in Essential Hypertension: A Randomized Controlled Study. Int J Clin Exp Hypertens. 2018;1(1): 007-014.

Published: 16 February 2018

Research Article: The Relation between Red Cell Distribution Width and Hypertension, Dipper Pattern and End-Organ Damage Independent from Vitamin B12, Folic Acid and Ferritin Levels

Ismail Bolat*, Hamdi Pusuroglu, Ozgur Surgit, Umut Somuncu, Yusuf Demir, Sinem Ozyilmaz, Ali Gungor and Yavuz Okulu

Background and Aim: Many studies have found association between Red Cell Distribution Width (RDW) values and hypertension, dipping pattern, and end-organ damage. RDW values are affected by blood vitamin B12, iron, and folic acid levels, parameters that were not assessed in the previous studies. The aim of our study was to evaluate the relation between RDW and hypertension, dipper pattern, and end-organ damage independently from vitamin B12, folic acid, and ferritin levels in newly diagnosed hypertensive patients.
Material and Methods: Hundred and sixty-three hypertensive patients with two different-time measured office blood pressure > 140/90 mmHg, and 85 normotensive subjects with office blood pressure < 140/90 mmHg were included in the study. Ambulatory blood pressure monitoring was performed in all participants. Twenty-two participants were excluded because of white-coat syndrome and 10 subjects due to masked-hypertension. Patients were classified into three subgroups according to ambulatory blood pressure measurements; non-dipper hypertensive (n = 88), dipper hypertensive (n = 53), and normotensive (n = 75). Left ventricular mass index, glomerular filtration rate, and microalbuminuria were measured to determine end-organ damage. RDW and serum levels of ferritin, vitamin B12 and folic acid were measured in all participants.
Results: When we evaluated all participants without taking the baseline values of vitamin B12, folic acid and ferritin into account, RDW was found higher in non-dipper hypertension group but the difference did not reach statistically significant level (p = 0.263). When participants with vitamin B12, ferritin and folic acid levels below normal levels were excluded, the mean RDW decreased but no statistically significant difference between the groups was detected (p = 0.187). RDW was positively correlated with LVMI, age and urine albumin in hypertensive patients (r = 0.476, p < 0.001; r = 0.342, p < 0.001; r = 0.212, p = 0.006, respectively); but not with GFR (r = -0.0015, p = 0.852).
Conclusion: In conclusion, in newly diagnosed hypertensive patients, although RDW levels were associated with LVMI and microalbuminuria, hypertensive patient group was not statistically different from normotensive group; and non-dipper hypertensive group was not statistically different from dipper hypertensive group. It was found that vitamin B12, folic acid and ferritin levels did not affect this correlation.

Cite this Article: Bolat I, Pusuroglu H, Surgit O, Somuncu U, Demir Y, et al. The Relation between Red Cell Distribution Width and Hypertension, Dipper Pattern and End-Organ Damage Independent from Vitamin B12, Folic Acid and Ferritin Levels. Int J Clin Exp Hypertens. 2018;1(1): 001-006.

Published: 31 January 2018

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