engleski

Effect of ACE-Inhibitor vs. ACE-Inhibitor/Ca2+Antagonist Combination on Metabolic Control in Type 2 Diabetic Hypertensive Patients

The aim of the study was to compare the effect of two different therapeutic approaches on lipid metabolism and glycaemic regulation in type 2 diabetic patients at similar blood pressure reduction. Sixty-four type 2 diabetic patients with newly diagnosed arterial hypertension (36 male and 28 female ; age-range: 56± ; ; ; 8.45 yrs ; diabetes duration: 12± ; ; ; 4.85 yrs) were studied. Thirty patients were treated with lisinopril (group A) and 34 with a lisinopril/nifedipin combination (group B). Patients were followed during a 2-year period. Systolic (SBP) and diastolic (DBP) blood pressure, albumin excretion rate (AER), glycated hemoglobin (A1c), total cholesterol, HDL, LDL, triglycerides, and body mass index (BMI) were measured at baseline, 6, 12, and 24 months of active treatment. At the beginning of the study, no significant difference was found in predictive variables between the two treatment groups. At the end of the study, a significant difference was found in A1c (p=0.040), but not in blood pressure (SBP: p=0.069 vs. DBP: p=0.188) and BMI (p=0.426). At the end of the study significant reductions in SBP (p=0.0001), DBP (p=0.0005), A1c (p=0.004), total cholesterol (p=0.002), and LDL (p=0.004) were found, but no reductions in AER (p=0.339) and BMI (P=0.470). Significant reduction was found in group B for A1c (p=0.010), total cholesterol (p=0.027) and LDL (p=0.037), but not in group A. No significant reduction in BMI was found in group A (p=0.220), nor in group B (p=0.851). Reduction of BP at the end of the study was similar in the two treatment groups. After a 2-yr treatment period, patients in group B had lower A1c, total cholesterol and LDL values compared to group A. A lisinopril/nifedipin combination seems to have a favorable effect on metabolic control in type 2 diabetic patients.

diabetic dylipidemia ; hypertension ; antyhypertensives

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