Additive beneficial effects of atorvastatin combined with amlodipine in patients with mild-to-moderate hypertension

Kwang Kon Koh, Michael J. Quon, Seung Hwan Han, Yonghee Lee, Jeong Beom Park, Soo Jin Kim, Yesl Koh, Eak Kyun Shin

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

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 languageEnglish
Pages (from-to)319-325
Number of pages7
JournalInternational Journal of Cardiology
Volume146
Issue number3
DOIs
StatePublished - 3 Feb 2011

Keywords

  • Adiponectin
  • Calcium channel blocker
  • Endothelial function
  • HMG-CoA reductase inhibitor
  • Hypertension
  • Insulin resistance

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