RETRACTED ARTICLE: Different Aspects of Sartan + Calcium Antagonist Association Compared to the Single Therapy on Inflam
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Different Aspects of Sartan + Calcium Antagonist Association Compared to the Single Therapy on Inflammation and Metabolic Parameters in Hypertensive Patients Giuseppe Derosa,1,2,6 Arrigo F. G. Cicero,3 Anna Carbone,4 Fabrizio Querci,5 Elena Fogari,1 Angela D’Angelo,1 and Pamela Maffioli1
Abstract—This study aims to evaluate the effects of an angiotensin receptor blocker (ARB)/calcium channel blocker combination on blood pressure control, lipid profile, insulin sensitivity, and inflammation markers. We randomized 276 hypertensive patients to olmesartan 20 mg, amlodipine 10 mg, or a single pill containing an olmesartan/amlodipine combination 20/5 mg for 12 months. We evaluated the following: body weight, systolic and diastolic blood pressure, fasting plasma glucose, fasting plasma insulin (FPI), M value, lipid profile, adiponectin (ADN), high sensitivity C-reactive protein (Hs-CRP), monocyte chemoattractant protein-1 (MCP-1), and macrophage migration inhibitory factor-1β (MIP-1β). Olmesartan/amlodipine combination better reduced blood pressure, FPI, homeostasis model assessment index, and increased M value and ADN compared to olmesartan and amlodipine monotherapies. Olmesartan/amlodipine significantly decreased Hs-CRP, MCP-1, and MIP-1β. In this multicenter, randomized, double-blind, clinical study, ARB/calcium antagonist combination resulted to be more effective than single monotherapies in reducing blood pressure, in improving insulin sensitivity, and in reducing inflammation parameters in patients with stage I essential hypertension. KEY WORDS: adiponectin; amlodipine; high sensitivity C-reactive protein; monocyte chemoattractant protein-1; olmesartan.
at least 75 % of patients with hypertension require combination therapy to maintain blood pressure control [3]. It has been demonstrated that combining antihypertensive agents from different classes produces blood pressure reductions approximately five times greater than doubling the dose of any single agent [4]. Among different first-line antihypertensive drug classes, angiotensin receptor blockers (ARBs) are characterized by both good effectiveness and tolerability; furthermore, the interruption of the renin–angiotensin cascade is related with several benefits in targeting organ protection and cardiovascular prevention [5]. In particular olmesartan medoxomil is an angiotensin receptor blocker with a long history of use in clinical practice, it has been shown to provide greater reductions in 24-h ambulatory blood pressure monitoring than several other angiotensin receptor blockers, despite similar reductions in office blood pressure [6]. On the other hand, dihydropyridine calcium channel blocker (CCBs) decreases blood pres-
INTRODUCTION Hypertension is a well-known risk factor for major cardiovascular outcomes, including myocardial infarction, stroke, and heart failure [1], and it is associated with substantial costs for the health-care system, at an estimated $503.2 billion [2]. It has been estimated that 1
Department of Internal Medicine and Therapeutics, University of Pa
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