Carvedilol-lisinopril combination therapy and endothelial function in obese individuals with hypertension

Aaron S Kelly, J. Michael Gonzalez-Campoy, Kyle Rudser, Harold Katz, Andrea M. Metzig, Melissa Thalin, Alan J. Bank

Research output: Contribution to journalArticle

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Abstract

The authors hypothesized that carvedilol controlled-release plus lisinopril combination therapy (C+L) would increase endothelial function and decrease oxidative stress to a greater extent than hydrochlorothiazide plus lisinopril combination therapy (H+L) in obese patients with hypertension. Twenty-five abdominally obese patients (aged 54.4±7.3 years; 14 women) with hypertension/prehypertension were enrolled in a 7-month (two 3-month treatment periods separated by a 1-month washout), randomized, double-blind, controlled, crossover clinical trial comparing C+L vs H+L. Endothelial function, measured by digital reactive hyperemic index (RHI), circulating oxidized low-density lipoprotein (oxLDL), 8-isoprostane, and asymmetric dimethylarginine (ADMA) were obtained at baseline, post-period 1, post-washout, and post-period 2. Analyses were adjusted for baseline measurements by analysis of covariance, with robust variance estimation for confidence intervals and P values. C+L treatment compared to H+L treatment significantly improved RHI (0.74, 95% confidence interval, 0.31-1.19, P=.001). This difference persisted after adjustment for the change in systolic blood pressure. No significant treatment differences were observed for oxLDL, 8-isoprostane, or ADMA. These data provide evidence that independent of blood pressure-lowering, C+L therapy improves endothelial function to a greater extent than H+L therapy. Levels of oxidative stress were not significantly different between treatments, suggesting that other mechanisms may be responsible for the improvement in endothelial function.

Original languageEnglish (US)
Pages (from-to)85-91
Number of pages7
JournalJournal of Clinical Hypertension
Volume14
Issue number2
DOIs
StatePublished - Feb 1 2012

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Lisinopril
Hypertension
8-epi-prostaglandin F2alpha
Therapeutics
Blood Pressure
Oxidative Stress
Prehypertension
Confidence Intervals
carvedilol
Controlled Clinical Trials
Cross-Over Studies

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Carvedilol-lisinopril combination therapy and endothelial function in obese individuals with hypertension. / Kelly, Aaron S; Gonzalez-Campoy, J. Michael; Rudser, Kyle; Katz, Harold; Metzig, Andrea M.; Thalin, Melissa; Bank, Alan J.

In: Journal of Clinical Hypertension, Vol. 14, No. 2, 01.02.2012, p. 85-91.

Research output: Contribution to journalArticle

Kelly, Aaron S ; Gonzalez-Campoy, J. Michael ; Rudser, Kyle ; Katz, Harold ; Metzig, Andrea M. ; Thalin, Melissa ; Bank, Alan J. / Carvedilol-lisinopril combination therapy and endothelial function in obese individuals with hypertension. In: Journal of Clinical Hypertension. 2012 ; Vol. 14, No. 2. pp. 85-91.
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