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J Renin Angiotensin Aldosterone Syst ; 16(4): 967-74, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25784709

RESUMO

INTRODUCTION: The purpose of this study was to compare the effects of benazepril and losartan on endothelial function and vascular stiffness, in patients with diabetes mellitus and hypertension. MATERIALS AND METHODS: We included hypertensive diabetic patients with an office systolic blood pressure (BP) ⩾ 130 mmHg and/or diastolic BP ⩾ 80 mmHg. Patients were rolled over to amlodipine for 6 weeks, then we performed C-reactive protein assays, BP measurement and vascular tests; next, patients were randomized to benazepril or losartan. The tests were repeated after 12 weeks. RESULTS: We randomized 14 patients to benazepril and 16 to losartan. There were no differences in systolic (139 versus 134 mmHg, p = 0.618) and diastolic (82 versus 80 mmHg, p = 0.950) BP at the end of the study. C-reactive protein values were lower in the benazepril group (0.38 versus 0.42 mg/dl, p = 0.020). There was a slightly higher flow-mediated vasodilation (FMD) response in the benazepril group (45% increase, p = 0.057) than in the losartan group (19% increase, p = 0.132). Both central systolic BP (129 versus 123 mmHg, p = 0.934) and carotid-femoral pulse wave velocity (cfPWV) (8.5 versus 8.5 m/s, p = 0.280) were the same between groups. CONCLUSIONS: Hypertensive diabetic patients using benazepril had a greater reduction in C-reactive protein, and a slight improvement in FMD, than those taking losartan.


Assuntos
Benzazepinas/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Endotélio Vascular/fisiopatologia , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Losartan/uso terapêutico , Rigidez Vascular/efeitos dos fármacos , Aorta/efeitos dos fármacos , Aorta/fisiopatologia , Benzazepinas/efeitos adversos , Benzazepinas/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Proteína C-Reativa , Estudos de Coortes , Diabetes Mellitus Tipo 2/fisiopatologia , Endotélio Vascular/efeitos dos fármacos , Feminino , Humanos , Losartan/efeitos adversos , Losartan/farmacologia , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso
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