Abstract
Background: We hypothesized that atorvastatin combined with amlodipine has additive beneficial vascular and metabolic effects that are superior to monotherapy in patients with hypertension. Methods: Forty-two patients were given atorvastatin 20 mg/day and placebo, atorvastatin 20 mg/day and amlodipine 10 mg/day, or amlodipine 10 mg/day and placebo during each 2-month treatment period of a randomized, single-blind, placebo-controlled cross-over trial with two 2-month washout periods. Results: Atorvastatin combined with amlodipine or amlodipine alone significantly reduced blood pressure to a greater extent than atorvastatin alone (all P < 0.001 by ANOVA). Atorvastatin combined with amlodipine significantly reduced plasma malondialdehyde and improved flow-mediated dilation to a greater extent than atorvastatin or amlodipine alone (all P < 0.001 by ANOVA). Atorvastatin therapy significantly increased insulin levels (P = 0.004) and decreased plasma adiponectin levels (P = 0.016) and insulin sensitivity (determined by QUICKI; P = 0.026) relative to baseline measurements. Amlodipine therapy significantly decreased insulin levels (P = 0.001) and increased adiponectin levels (P < 0.001) and insulin sensitivity (P = 0.003) relative to baseline measurements. Atorvastatin combined with amlodipine therapy significantly increased adiponectin levels (P < 0.001) and insulin sensitivity (P = 0.034) relative to baseline measurements. Effects of all three therapeutic arms on adiponectin levels and insulin sensitivity were statistically significant (P < 0.001 by ANOVA). Conclusions: Atorvastatin combined with amlodipine therapy improves endothelial function and increases adiponectin levels and insulin sensitivity to a greater extent than monotherapy with either drug in hypertensive patients.
Original language | English |
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Pages (from-to) | 319-325 |
Number of pages | 7 |
Journal | International Journal of Cardiology |
Volume | 146 |
Issue number | 3 |
DOIs | |
State | Published - 3 Feb 2011 |
Keywords
- Adiponectin
- Calcium channel blocker
- Endothelial function
- HMG-CoA reductase inhibitor
- Hypertension
- Insulin resistance