Additive beneficial cardiovascular and metabolic effects of combination therapy with ramipril and candesartan in hypertensive patients.

Additive beneficial cardiovascular and metabolic effects of combination therapy with ramipril and candesartan in hypertensive patients. Research Abstract Details 

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Additive beneficial cardiovascular and metabolic effects of combination therapy with ramipril and candesartan in hypertensive patients. Abstract Text:

Kwang Kon Koh,Michael J Quon,Yonghee Lee,Seung Hwan Han,Jeong Yeal Ahn,Wook-Jin Chung,Jeong-A Kim,Eak Kyun Shin,Kwang Kon Koh,Michael J Quon,Yonghee Lee,Seung Hwan Han,Jeong Yeal Ahn,Wook-Jin Chung,Jeong-A Kim,Eak Kyun Shin,

AIMS: Ramipril and candesartan have distinct mechanisms of action to improve endothelial function. Therefore, we hypothesized that combination therapy has additive beneficial effects to simultaneously improve endothelial dysfunction and adipocytokine profiles in patients with hypertension. METHODS AND RESULTS: Thirty-four patients were given ramipril 10 mg and placebo, ramipril 10 mg and candesartan 16 mg, or candesartan 16 mg and placebo daily in a randomized, double-blind, placebo-controlled cross-over trial with three treatment arms and two washout periods (each 2 months). Ramipril, candesartan, or combination therapy reduced blood pressure, improved flow-mediated dilation, and increased plasma adiponectin levels when compared with baseline values. However, combination therapy improved these outcome measures to a greater extent than either ramipril or candesartan alone (P < 0.001 and P = 0.016 for systolic and diastolic blood pressure, P < 0.001 and P = 0.048 for flow-mediated dilation and adiponectin levels by ANOVA). In addition, combination therapy reduced plasma leptin levels to a greater extent than either ramipril or candesartan alone (P = 0.042 by ANOVA). There were correlations between percent changes in adiponectin levels and percent changes in insulin sensitivity (determined by QUICKI) (r = 0.319, P = 0.066) following ramipril therapy, percent changes in QUICKI (r = 0.374, P = 0.029) following combination therapy, and percent changes in QUICKI (r = 0.607, P < 0.001) following candesartan therapy. CONCLUSION: Ramipril in combination with candesartan improves blood pressure, endothelial function, and adipocytokine profiles to a greater extent than monotherapy with either drug in hypertensive patients.

Additive beneficial cardiovascular and metabolic effects of combination therapy with ramipril and candesartan in hypertensive patients. Publishing Authors By Initials

KK Koh,MJ Quon,Y Lee,SH Han,JY Ahn,WJ Chung,JA Kim,EK Shin,KK Koh,MJ Quon,Y Lee,SH Han,JY Ahn,WJ Chung,JA Kim,EK Shin,

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Additive beneficial cardiovascular and metabolic effects of combination therapy with ramipril and candesartan in hypertensive patients. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: European heart journal

VOLUME: 28

Page Numbers: 1440-7

Journal Abbreviation: Eur. Heart J.

ISSN: 0195-668X

DAY: 5

MONTH: 05

YEAR: 2007

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LANGUAGE: eng

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AFFILIATION: Cardiology, Gachon Medical School, Incheon, Korea. kwangk@gilhospital.com

Country: England

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MEDLINETA: Eur Heart J

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