Effects of combination therapy with olmesartan and azelnidipine on serum
osteoprotegerin in patients with hypertension.
Author(s): Uzui H(1), Morishita T, Nakano A, Amaya N, Fukuoka Y, Ishida K, Arakawa K, Lee
JD, Tada H.
Affiliation(s): Author information:
(1)1Department of cardiovascular Medicine, Faculty of Medical Sciences,
University of Fukui, Fukui, Japan.
Publication date & source: 2014, J Cardiovasc Pharmacol Ther. , 19(3):304-9
BACKGROUND: Vascular calcification is a potent predictor of plaque instability
and cardiac events. Osteoprotegerin (OPG), well-known vascular calcification
mediator, is a signaling molecule involved in bone remodeling, which has been
implicated in the regulation of vascular calcification and atherogenesis. The
purpose of this study was to compare the combination treatments of
olmesartan/azelnidipine and olmesartan/diuretics on serum bone-related markers in
patients with essential hypertension.
METHODS AND RESULTS: A total of 48 patients with hypertension treated with 20 mg
olmesartan were randomized to receive combination treatment with 16 mg
azelnidipine (O/A group) or diuretics (1 mg indapamide; O/D group) for 12 months.
Osteoprotegerin, matrix metalloproteinase 2 (MMP-2), and high-sensitive CRP
(hs-CRP) were measured after 3 and 12 months of treatment. Cardio-ankle vascular
index (CAVI) was measured as the arterial stiffness using a VaSera CAVI
instrument at the same time points. In both groups, the systolic and diastolic
blood pressure reduction is similar. Serum OPG, MMP-2, and hs-CRP were
significantly decreased at 12 months in the O/A group (P < .05), while there were
no significant reductions in the O/D group. CAVI was significantly improved at 12
months in both the treatment groups. The improvement in CAVI was significantly
greater in the O/A group than in the O/D group.
CONCLUSION: Azelnidipine, but not indapamide, combined with olmesartan, improved
arterial stiffness and were associated with significant decrease in OPG, MMP-2,
and hs-CRP concentrations. These results suggest that the beneficial effects of
the combination treatments of olmesartan/azelnidipine on arterial stiffness are
mediated by alteration in bone-remodeling and inflammatory markers.
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