ACE inhibitor-based treatment and antihypertensive effects in patients with type 2 diabetes

E A Jarmuzewska, R Rocchi, A Guidoni, Arduino Aleksander Mangoni

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

AIM: The presence of hypertension significantly increases cardiovascular risk in diabetic patients. Different classes of antihypertensive drugs, by targeting different pathophysiological mechanisms and therapeutic targets, might provide different antihypertensive effects. The authors speculated that drugs specifically targeting the renin-angiotensin-aldosterone system provide better antihypertensive control than other therapeutic agents. METHODS: Fifty consecutive type 2 diabetic patients with hypertension (M:F 29:21) were followed for 3-9 yrs. Antihypertensive treatment was stable for the last 12 months and included angiotensin convertying enzyme (ACE) inhibitors (ACEI) alone in 8 patients (group IA), ACEI combined with other drugs in 11 patients (group IB) and non-ACEI treatment in 31 patients (group II), 23 of whom were treated with Ca-channel blockers and 8 were treated with beta-blockers alone or with diuretics. During the last month of the study a 3-7 days antihypertensive drugs wash-out was performed. Measurements were performed in sitting position in the same ambulatory conditions, in supine position after 20 min of absolute rest, and in motionless standing station after quickly rising up from sitting rest. RESULTS: Groups IA, IB, and II had similar blood pressure values during antihypertensive therapy within the last year. However, blood pressure values after antihypertensive drug wash-out were significantly higher in groups IA and IB vs. group II (SBP and DBP resting sitting position, P=0.039 and P=0.014 respectively; SBP and DBP in standing position, P=0.001 and P=0.016, respectively). CONCLUSION: These data show that the underlying condition in terms of pathophysiologic mechanisms is more severe in groups IA and IB, including a greater increase of peripheral resistance. Thus we may conclude that the antihypertensive effect of ACEI is greater than other classes of antihypertensive drugs.
Original languageEnglish
Pages (from-to)207-216
Number of pages10
JournalPanminerva Medica
Volume50
Issue number3
Publication statusPublished - 1 Sep 2008

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Angiotensins
Enzyme Inhibitors
Type 2 Diabetes Mellitus
Antihypertensive Agents
Posture
Angiotensin-Converting Enzyme Inhibitors
Therapeutics
Drug Delivery Systems
Blood Pressure
Hypertension
Supine Position
Renin-Angiotensin System
Diuretics
Vascular Resistance

Keywords

  • Aged
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Blood Pressure
  • Diabetes Mellitus, Type 2
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension
  • Male
  • Middle Aged
  • Time Factors
  • Treatment Outcome

Cite this

Jarmuzewska, E. A., Rocchi, R., Guidoni, A., & Mangoni, A. A. (2008). ACE inhibitor-based treatment and antihypertensive effects in patients with type 2 diabetes. Panminerva Medica, 50(3), 207-216.

ACE inhibitor-based treatment and antihypertensive effects in patients with type 2 diabetes. / Jarmuzewska, E A; Rocchi, R; Guidoni, A; Mangoni, Arduino Aleksander.

In: Panminerva Medica, Vol. 50, No. 3, 01.09.2008, p. 207-216.

Research output: Contribution to journalArticle

Jarmuzewska, EA, Rocchi, R, Guidoni, A & Mangoni, AA 2008, 'ACE inhibitor-based treatment and antihypertensive effects in patients with type 2 diabetes', Panminerva Medica, vol. 50, no. 3, pp. 207-216.
Jarmuzewska EA, Rocchi R, Guidoni A, Mangoni AA. ACE inhibitor-based treatment and antihypertensive effects in patients with type 2 diabetes. Panminerva Medica. 2008 Sep 1;50(3):207-216.
Jarmuzewska, E A ; Rocchi, R ; Guidoni, A ; Mangoni, Arduino Aleksander. / ACE inhibitor-based treatment and antihypertensive effects in patients with type 2 diabetes. In: Panminerva Medica. 2008 ; Vol. 50, No. 3. pp. 207-216.
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N2 - AIM: The presence of hypertension significantly increases cardiovascular risk in diabetic patients. Different classes of antihypertensive drugs, by targeting different pathophysiological mechanisms and therapeutic targets, might provide different antihypertensive effects. The authors speculated that drugs specifically targeting the renin-angiotensin-aldosterone system provide better antihypertensive control than other therapeutic agents. METHODS: Fifty consecutive type 2 diabetic patients with hypertension (M:F 29:21) were followed for 3-9 yrs. Antihypertensive treatment was stable for the last 12 months and included angiotensin convertying enzyme (ACE) inhibitors (ACEI) alone in 8 patients (group IA), ACEI combined with other drugs in 11 patients (group IB) and non-ACEI treatment in 31 patients (group II), 23 of whom were treated with Ca-channel blockers and 8 were treated with beta-blockers alone or with diuretics. During the last month of the study a 3-7 days antihypertensive drugs wash-out was performed. Measurements were performed in sitting position in the same ambulatory conditions, in supine position after 20 min of absolute rest, and in motionless standing station after quickly rising up from sitting rest. RESULTS: Groups IA, IB, and II had similar blood pressure values during antihypertensive therapy within the last year. However, blood pressure values after antihypertensive drug wash-out were significantly higher in groups IA and IB vs. group II (SBP and DBP resting sitting position, P=0.039 and P=0.014 respectively; SBP and DBP in standing position, P=0.001 and P=0.016, respectively). CONCLUSION: These data show that the underlying condition in terms of pathophysiologic mechanisms is more severe in groups IA and IB, including a greater increase of peripheral resistance. Thus we may conclude that the antihypertensive effect of ACEI is greater than other classes of antihypertensive drugs.

AB - AIM: The presence of hypertension significantly increases cardiovascular risk in diabetic patients. Different classes of antihypertensive drugs, by targeting different pathophysiological mechanisms and therapeutic targets, might provide different antihypertensive effects. The authors speculated that drugs specifically targeting the renin-angiotensin-aldosterone system provide better antihypertensive control than other therapeutic agents. METHODS: Fifty consecutive type 2 diabetic patients with hypertension (M:F 29:21) were followed for 3-9 yrs. Antihypertensive treatment was stable for the last 12 months and included angiotensin convertying enzyme (ACE) inhibitors (ACEI) alone in 8 patients (group IA), ACEI combined with other drugs in 11 patients (group IB) and non-ACEI treatment in 31 patients (group II), 23 of whom were treated with Ca-channel blockers and 8 were treated with beta-blockers alone or with diuretics. During the last month of the study a 3-7 days antihypertensive drugs wash-out was performed. Measurements were performed in sitting position in the same ambulatory conditions, in supine position after 20 min of absolute rest, and in motionless standing station after quickly rising up from sitting rest. RESULTS: Groups IA, IB, and II had similar blood pressure values during antihypertensive therapy within the last year. However, blood pressure values after antihypertensive drug wash-out were significantly higher in groups IA and IB vs. group II (SBP and DBP resting sitting position, P=0.039 and P=0.014 respectively; SBP and DBP in standing position, P=0.001 and P=0.016, respectively). CONCLUSION: These data show that the underlying condition in terms of pathophysiologic mechanisms is more severe in groups IA and IB, including a greater increase of peripheral resistance. Thus we may conclude that the antihypertensive effect of ACEI is greater than other classes of antihypertensive drugs.

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KW - Middle Aged

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