Acarbose effects on vascular stiffness in patients with arterial hypertension and metabolic syndrome

Aim. To assess perspectives of pulse wave velocity (PWV) correction during acarbose treatment in patients with impaired glucose tolerance (IGT) and arterial hypertension (AH). Material and methods. An open clinical trial included 45 patients (18 males and 27 females) aged 18-60 years, with body mass index (BMI) > 25 kg/m2, IGT, and elevated blood pressure (BP). After envelope method randomization, all patients were divided into three groups: active acarbose treatment groups (maximal dose 150 mg/d or 300 mg/d) and previous therapy group. In all groups, non-pharmaceutical lifestyle modification and weight control measures were performed (diet, increased physical activity). Treatment phase lasted for 24 weeks. Dynamics of BP, carbohydrate and lipid metabolism, PWV for vessels of various diameters, by Complior protocol and with Colson device, were registered. Results. Acarbose treatment resulted not only in carbohydrate and lipid metabolism improvement, but also in artery elasticity improvement among overweight patients with IGT. Conclusion. In patients with IGT and excess body weight, acarbose in doses of 150-300 mg/d, added to nonpharmaceutical intervention, was associated with PWV normalization, and could be regarded as a sign of beneficial acarbose influence on large vessel elasticity.

1. Asmar R, Benetos A, London GM, et al. Aortic distensibility in normotensive, untreated and treated hypertensive patients. Blood Pressure 1995; 4: 48-54.

2. Blacher J, Asmar R, Djane S. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension 1999; 33: 1111-7.

3. Donahue R, Abbott R, Reed D, Yano K. Post-challenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program Diabetes 1987; 36: 689-92.

4. Hanefeld M, Chiasson J, Koehler C. Acarbose slows progression of intima-media thickness of the carotid arteries in the subjects with impaired glucose tolerance. Stroke 2004; 1073-8.

5. Koya D, King G. Protein kinase C activation and the development of diabetic complications. Diabetes 1998; 47(6): 859-66.

6. Nappo F, Esposito K. Postprandial endothelial activation in healthy subjects and in type 2 diabetic patient: role of fat and carbohydrate meals. JACC 2002; 39: 1145-50.

7. Аронов Д.М, Бубнова М.Г. Разнообразие механизмов действия акарбозы и ее роль в профилактике сахарного диабета 2 типа и сердечно-сосудистых заболеваний. Клин фармак тер 2004; 13(4): 34-8.

8. Мартынов А.И., Остроумова О.Д., Синицын В.Е. и др. Растяжимость аорты при артериальной гипертензии. Кардиология 2001; 2: 59-65.

9. Мычка В.Б., Богиева Р.М., Мамырбаева К.М., Чазова И.Е. Терапия акарбозой как профилактика множественных сердечно-сосудистых факторов риска метаболического синдрома. Артер гиперт 2003; 9(2): 51-4.

10. Мычка В.Б., Богиева Р.М., Мамырбаева К.М., Чазова И.Е. Акарбоза – средство профилактики множественных сердечно-сосудистых факторов риска у больных с метаболическим синдромом. Клин фармак тер 2003; 12(2): 43-9.

11. Мычка В.Б., Чазова И.Е., Беленков Ю.Н. Первые результаты Российской программы по изучению эффективности применения Акарбозы у Пациентов с наРушенной толЕрантностью к глюкозе и артериаЛЬной гипертонией («АПРЕЛЬ») Кардиоваск тер профил 2004; 3(6), ч.I: 66-73.