1
|
Hanna SM, Rabea HM, Abdelrahim MEA, Mahmoud HB. Effect of Fixed-dose Combination Amlodipine/Valsartan in Comparison to Two Drug Combination Nebivolol/Valsartan on 24-Hour Ambulatory Blood Pressure. Curr Hypertens Rev 2023; 19:123-129. [PMID: 36998137 DOI: 10.2174/1573402119666230330082128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Nebivolol has a dual mechanism of action, exerting a moderate b- blockade effect and reducing peripheral arterial resistance, as a result, the antihypertensive effect of nebivolol may be higher than that of a potent vasodilator CCB such as amlodipine. AIM The study evaluated the effect of two nebivolol/valsartan on 24 hour ambulatory blood pressure versus amlodipine/valsartan in grade II or III hypertension patients or having uncontrolled BP despite treatment. Ambulatory blood pressure monitoring is a powerful method to monitor the changes in blood pressure over the 24 hour. MATERIALS AND METHODS A total of 74 from 90 patients continued the study. Fourty patients received amlodipine 10 mg/valsartan 160 mg (group I), and thirty-four patients received nebivolol 5 mg/ valsartan 160 mg (group II). Peripheral blood pressure readings were measured at randomization at 6 and 12 weeks. Ambulatory blood pressure was measured at randomization and 12 weeks. RESULTS Both drug combinations showed high efficacy in reducing peripheral and 24 hour ambulatory BP. There was no statistically significant difference between the groups in lowering peripheral systolic and diastolic blood pressure at 6 and 12 weeks. Furthermore, both groups failed to show any significant difference in reducing 24 hour SBP and DBP. Regarding day SBP, the blood pressure dropped by -5.63 ± 14.87 in group I and -6.25 ± 11.59 in group II (p = 0.844). Also, group I reduced the day DBP average by -2.53 ± 9.83 and group II by -3.61 ± 9.78 (p = 0.640). In addition, both drug combinations had no statistically significant difference in lowering night SBP and DBP average. CONCLUSION Both treatment groups reached the target ambulatory blood pressure, and there was no statistically significant difference between both groups as a regard reduction in all ambulatory blood pressure readings.
Collapse
Affiliation(s)
- Selvia M Hanna
- Cardiovascular Department, Beni-Suef University Hospital, Beni-Suef, Egypt
| | - Hoda M Rabea
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed E A Abdelrahim
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Hesham B Mahmoud
- Department of Cardiology, Beni-Suef University Hospital, Beni-Suef, Beni-Suef, Egypt
| |
Collapse
|
2
|
Sultan EZM, Rabea H, Elberry AA, Mahmoud HB. Effect of Amlodipine/Nebivolol combination therapy on central BP and PWV compared to Amlodipine/Valsartan combination therapy. Egypt Heart J 2022; 74:15. [PMID: 35286492 PMCID: PMC8921398 DOI: 10.1186/s43044-022-00254-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pulse wave velocity (PWV) and central blood pressure (CBP) have been intoduced into managment of hypertensive patients. PWV is positively correlated with arterial wall stiffness while central aortic pressure becomes better predictor of cardiovascular outcome than peripheral pressure. Reduction in CBP provides protective properties against subclinical organ damage. This work aims to investigate the effect of a new combination therapy of Amlodipine/Nebivolol (A/N) on central BP, peripheral BP and PWV. The results of using this combination will be compared to the well-established fixed-dose combination of Amlodipine/Valsartan (A/V). The study conducted between October 2018 and August 2020. One hundred and two hypertensive patients were assigned for Amlodipine 10 mg/Valsartan 160 mg combination therapy (A/V, n = 52) or Amlodipine 10 mg/Nebivolol 5 mg combination therapy (A/N, n = 50) by simple 1:1 randomization. Office, central blood pressure and PWV were measured on first (0 week), second (4–8 weeks) and third visit (10–12). Difference in BP (in each arm and between arms) was calculated along all visits. Results No statistical significant difference was found between A/V and A/N regarding age, gender, BMI and CV history. OBP, CBP and PWV were significantly reduced in each arm, but no differences were found when comparing both arm results to each other. Recorded side effects were insignificant. Conclusions The new combination therapy Amlodipine/Nebivolol (A/N) affords a significant reduction in CBP, PBP and PWV with minor and tolerable side effects. It has provided comparable results to Amlodipine/Valsartan (A/V) combination therapy.
Collapse
Affiliation(s)
- El-Zahraa M Sultan
- Cardiology Department, Beni-Suef University Hospital, Beni-Suef City, 62511, Egypt.
| | - Hoda Rabea
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef City, 62511, Egypt
| | - Ahmed A Elberry
- Department of Pharmacy Practice, Pharmacy Program, Batterjee Medical College, Jeddah, 21442, Saudi Arabia
| | | |
Collapse
|
3
|
de Havenon A, Petersen N, Wolcott Z, Goldstein E, Delic A, Sheibani N, Anadani M, Sheth KN, Lansberg M, Turan T, Prabhakaran S. Effect of dihydropyridine calcium channel blockers on blood pressure variability in the SPRINT trial: a treatment effects approach. J Hypertens 2022; 40:462-469. [PMID: 34694261 PMCID: PMC11284837 DOI: 10.1097/hjh.0000000000003033] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Increased visit-to-visit blood pressure variability (vvBPV) has negative effects on multiple organ systems. Prior research has suggested that dihydropyridine calcium channel blockers (CCB) may reduce vvBPV, which we attempted to verify in a high-quality dataset with robust statistical methodology. METHODS We performed a post hoc analysis of the SPRINT trial and included participants who were on a dihydropyridine CCB either 0 or 100% of follow-up study visits. The primary outcome was vvBPV, defined as residual standard deviation (rSD) of SBP from month 6 until study completion. We estimated the average treatment effect of the treated (ATET) after augmented inverse-probability-weighting (AIPW) matching. RESULTS Of the 9361 participants enrolled in SPRINT, we included 5020, of whom 1959 were on a dihydropyridine CCB and 3061 were not; mean age was 67.4 ± 9.2 years, 34.5% were men, 65.9% were white, 49.4% were randomized to intensive blood pressure control, and the rSD was 10.1 ± 4.0 mmHg. Amlodipine represented greater than 95% of dihydropyridine CCB use. After AIPW matching of demographics and other antihypertensive medications, the ATET estimation for participants on a dihydropyridine CCB was an rSD that was 2.05 mmHg lower (95% CI -3.19 to -0.91). We did not find that other antihypertensive medications classes decreased vvBPV, and several increased it. CONCLUSION In the SPRINT trial, consistent use of a dihydropyridine CCB was associated with a 2 mmHg reduction in vvBPV. The implication of this hypothesis-generating finding in a high-quality dataset is that future trials to reduce vvBPV could consider using dihydropyridine CCBs.
Collapse
Affiliation(s)
- Adam de Havenon
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Nils Petersen
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Zoe Wolcott
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Eric Goldstein
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Alen Delic
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Nazanin Sheibani
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Mohammad Anadani
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Kevin N. Sheth
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Maarten Lansberg
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Tanya Turan
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| | - Shyam Prabhakaran
- Departments of Neurology at: University of Utah (AdH, AD, ZW, NS, EG), Washington University (MA), Yale University (NP, KS), Stanford University (ML), Medical University of South Carolina (TT), University of Chicago (SP)
| |
Collapse
|
4
|
Aondona MM, Ikya JK, Ukeyima MT, Gborigo TWJA, Aluko RE, Girgih AT. In vitro antioxidant and antihypertensive properties of sesame seed enzymatic protein hydrolysate and ultrafiltration peptide fractions. J Food Biochem 2020; 45:e13587. [PMID: 33346921 DOI: 10.1111/jfbc.13587] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 11/29/2022]
Abstract
The objective of this study was to determine the in vitro antioxidant and antihypertensive potentials of sesame seed protein hydrolysate and its membrane ultrafiltration peptide fractions in comparison to the unhydrolyzed protein. Sesame seed protein isolate (SESPI) was prepared from the defatted sesame seed meal and then hydrolyzed using consecutive additions of pepsin and pancreatin to yield sesame protein hydrolysate (SESPH). The SESPH was subjected to membrane ultrafiltration consecutively to obtain fractions with peptide sizes of <1, 1-3, 3-5, and 5-10 kDa, respectively, which were then assayed for in vitro antioxidant and antihypertensive properties. The results showed that protein hydrolysis and fractionation led to significant (p < .05) increases in the content of hydrophobic amino acids. Radical scavenging and metal ion chelation were also significantly (p < .05) enhanced by these treatments. Inhibition of linoleic acid oxidation was stronger with the 1.0 mg/ml of sesame peptide samples in comparison to the mild inhibitory effect exhibited by the 0.5 mg/ml of samples. The <1 kDa peptide fraction was the most active inhibitor (81%) against angiotensin converting enzyme, whereas the bigger peptides (>3-5 and 5-10 kDa) were the most effective (75%-85% ) inhibitors against renin. These sesame products could be used as therapeutic agents in the development of health enhancing foods for the prevention and management of chronic diseases. PRACTICAL APPLICATIONS: Bioactive peptides have been produced from plant protein sources through in vitro enzymatic activities. Sesame seed peptides have demonstrated multifunctional potential to act as antioxidative and antihypertensive agents that could be utilized as ingredients for the development of novel functional foods and nutraceuticals.
Collapse
Affiliation(s)
- Magdalene M Aondona
- Department of Food Science and Technology, University of Mkar, Gboko, Nigeria.,Department of Food Science and Technology, University of Agriculture, Makurdi, Benue State, Nigeria
| | - Julius K Ikya
- Department of Food Science and Technology, University of Agriculture, Makurdi, Benue State, Nigeria
| | - Moses T Ukeyima
- Department of Food Science and Technology, University of Agriculture, Makurdi, Benue State, Nigeria
| | - Tsav-Wua J A Gborigo
- Department of Home Economics, College of Education, Katsina-ala, Benue State, Nigeria
| | - Rotimi E Aluko
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Abraham T Girgih
- Department of Food Science and Technology, University of Agriculture, Makurdi, Benue State, Nigeria
| |
Collapse
|
5
|
Miyauchi S, Nagai M, Dote K, Kato M, Oda N, Kunita E, Kagawa E, Yamane A, Higashihara T, Takeuchi A, Tsuchiya A, Takahari K. Visit-to-visit Blood Pressure Variability and Arterial Stiffness: Which Came First: The Chicken or the Egg? Curr Pharm Des 2020; 25:685-692. [PMID: 30931845 DOI: 10.2174/1381612825666190329122024] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/25/2019] [Indexed: 11/22/2022]
Abstract
Earlier studies have shown that visit-to-visit blood pressure (BP) variability (VVV) served as a significant independent risk factor of stroke, specifically, in the high-risk elderly of cardiovascular disease (CVD). Although the mechanism is not clearly understood, arterial remodeling such as carotid artery, coronary artery and large aortic artery would be a strong moderator in the relationship between VVV and CVD incidence. Recent studies have provided evidence that VVV predicted the progression of arterial stiffness. While the class of antihypertensive agents is suggested to be an important determinant of VVV, long-acting calcium channel blockers use (CCBs) is associated with the reduction of VVV, and thus, is suggested to decrease the arterial stiffness. Specifically, the relationship between VVV and coronary arterial remodeling has never been reviewed until now. This article summarizes the recent literature on these topics. In the elderly hypertensives, strict BP control using CCBs could play a pivotal role in suppressing arterial stiffening via VVV reduction.
Collapse
Affiliation(s)
- Shunsuke Miyauchi
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Michiaki Nagai
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Keigo Dote
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Masaya Kato
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Noboru Oda
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Eiji Kunita
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Eisuke Kagawa
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Aya Yamane
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | | | - Arinori Takeuchi
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Akane Tsuchiya
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | | |
Collapse
|
6
|
Effect of Amlodipine/Valsartan Versus Nebivolol/Valsartan Fixed Dose Combinations on Peripheral and Central Blood Pressure. High Blood Press Cardiovasc Prev 2018; 25:407-413. [DOI: 10.1007/s40292-018-0286-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 10/27/2018] [Indexed: 10/27/2022] Open
|
7
|
Zhang L, Yang J, Li L, Liu D, Xie X, Dong P, Lin Y. Comparison of amlodipine versus other calcium channel blockers on blood pressure variability in hypertensive patients in China: a retrospective propensity score-matched analysis. J Comp Eff Res 2018; 7:651-660. [PMID: 29888950 DOI: 10.2217/cer-2017-0063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: Reducing the fluctuation of blood pressure has recently been recognized as a potential target for improving management of hypertension to prevent cardiovascular events, particularly for strokes. Some randomized controlled trials demonstrated that amlodipine can effectively reduce blood pressure as a well-established, long-acting calcium channel blocker (CCB). However, few data are available for amlodipine on blood pressure variability (BPV) in China in a real-world setting. This study aimed to assess the effect of amlodipine versus other CCB antihypertensive agents on BPV. Materials & methods: A retrospective propensity score-matched analysis was conducted, which retrieved the encounter data from 5582 hypertensive inpatients (with a median age of 69, female percentage of 48%, diastolic blood pressure ≥40 and <150 mmHg; systolic blood pressure (SBP) ≥70 mmHg and <260 mmHg), who had taken at least one antihypertensive agent and completed at least three SBP measurements during the visit. International Classification of Diseases was used to identify the hypertensive patients. BPV was calculated with standard deviation (SD) and coefficient of variation (CV) of SBP during a single inpatient visit. The Propensity Score Matching was used to balance the cohort of patients prescribed amlodipine or other CCBs. A series of appropriate statistical tests were applied to the propensity score-matched samples to examine the different effects on BPV. Additionally, the hypertensive patients with comorbidity such as coronary artery disease, diabetes mellitus, myocardial infarction, heart failure and chronic kidney disease were analyzed. Results: For the hypertensive patients (n = 1756, for each cohort), patients prescribed amlodipine showed lower BPV than patients prescribed other CCBs (12.90 vs 13.76 mmHg, p < 0.05 [SD] and 9.47 vs 10.06, p < 0.05 [CV]). For the hypertensive patients with comorbidity (n = 1080, for each cohort), patients prescribed amlodipine had lower BPV than patients prescribed other CCBs as well (13.24 vs 14.23 mmHg, p < 0.05 [SD] and 9.66 vs 10.28, p < 0.05 [CV]). Conclusion: amlodipine was associated with lower BPV than other CCBs for both hypertensive patients and hypertensive patients with comorbidity.
Collapse
Affiliation(s)
- Lin Zhang
- Department of Endocrinology, Beijing TongRen Hospital, Capital Medical University, Beijing, PR China
| | - JinKui Yang
- Department of Endocrinology, Beijing TongRen Hospital, Capital Medical University, Beijing, PR China
| | - LanTing Li
- Shanghai Palan DataRx Co. Ltd, Shanghai, PR China
| | | | | | - Peng Dong
- Pfizer Investment Co. Ltd, Beijing, PR China
| | - Yong Lin
- Shanghai Palan DataRx Co. Ltd, Shanghai, PR China
| |
Collapse
|
8
|
Antihypertensive Effect of Ethanolic Extract from Acanthopanax sessiliflorus Fruits and Quality Control of Active Compounds. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:5158243. [PMID: 29849899 PMCID: PMC5937377 DOI: 10.1155/2018/5158243] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/11/2018] [Accepted: 02/27/2018] [Indexed: 02/07/2023]
Abstract
Acanthopanax sessiliflorus (Rupr. & Maxim.) Seem., which belongs to the Araliaceae family, mainly inhabits Korea, China, and Japan. Traditionally, Acanthopanax species have been used as treatment for several diseases such as diabetes, tumors, and rheumatoid arthritis. Especially, its fruits have many biological functions including antitumor, immunostimulating, antithrombosis, and antiplatelet activities. Recently, the extract of A. sessiliflorus fruit has been reported to have antithrombotic and antiplatelet activities related to the alleviation of hypertension. Therefore, we investigated the antihypertensive effect of ethanolic extract from A. sessiliflorus fruits (DHP1501) through in vivo, ex vivo, and in vitro studies. In this study, DHP1501 demonstrated free radical scavenging capacity, enhanced endothelial nitric oxide (NO) production, and inhibited angiotensin-converting enzyme (ACE) activity in spontaneously hypertensive rats (SHRs), resulting in the improvement of vascular relaxation and decrease in blood pressure in the hypertensive animal model. These results suggest that A. sessiliflorus fruit extract may be a promising functional material for the prevention and treatment of hypertension. Furthermore, this study demonstrated the utility of MS-based active compounds for the quality control of DHP1501.
Collapse
|