Comparative effectiveness of perindopril and enalapril in patients with arterial hypertension and obesity
Abstract
Aim. To assess the antihypertensive effectiveness of perindopril and enalapril, as well as their effects on metabolic parameters, in patients with arterial hypertension (AH) and obesity (O).
Material and methods. This blind, randomized, controlled, parallel comparative study included 60 patients with AH and O, who were administered perindopril or enalapril for 24 weeks.
Results. Perindopril demonstrated significantly better antihypertensive effectiveness, cardio-, angio-, and nephroprotection, as well as an improvement in lipid, carbohydrate, and purine metabolism parameters. In patients with AH and O, only perindopril had beneficial effects on insulin resistance, hyperleptinemia, and inflammation. In contrast to enalapril treatment, perindopril therapy was associated with a marked improvement in anthropometry parameters and a reduction in fat tissue deposits.
Conclusion. In patients with a combination of AH and O, perindopril was superior to enalapril in terms of antihypertensive effectiveness, organ protection, and the effects on key humoral factors determining body mass increase and blood pressure elevation.
About the Authors
S. V. Nedogoda
Volgograd State Medical University
Russian Federation
Volgograd
Russian Federation
Volgograd
A. A. Ledyaeva
Volgograd State Medical University
Russian Federation
Volgograd
Russian Federation
Volgograd
E. V. Chumachok
Volgograd State Medical University
Russian Federation
Volgograd
Russian Federation
Volgograd
V. V. Tsoma
Volgograd State Medical University
Russian Federation
Volgograd
Russian Federation
Volgograd
G. G. Mazina
Volgograd State Medical University
Russian Federation
Volgograd
Russian Federation
Volgograd
A. S. Salasyuk
Volgograd State Medical University
Russian Federation
Volgograd
Russian Federation
Volgograd
I. N. Barykina
Volgograd State Medical University
Russian Federation
Volgograd
Russian Federation
Volgograd
References
1. Andrejak M, Santoni JP, Carre A, et al. A double-blind comparison of perindopril and HCTZ-amiloride in mild to moderate essential hypertension. Fundam Clin Pharmacol 1991; 5: 185-92.
2. Böhlen L, Bienz R, Doser M, et al. Metabolic neutrality of perindopril: focus on insulin sensitivity in overweight patients with essential hypertension. J Cardiovasc Pharmacol 1996; 27(6): 770-6.
3. Brasier A, Recinos A, Eledrisi M. Vascular Inflammation as a Cardiovascular Risk Factor Principles of Molecular Cardiology. Contemp Card 2005; VI: 577-604
4. Chen JMH, Heran BS, Wright JM, et al. Blood pressure lowering efficacy of diuretics as second-line therapy for primary hypertension. Cochrane Database Syst Rev 2009; 4: CD007187.
5. Dahlof B, Sever PS, Poulter NR, et al; ASCOT Investigators Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895-906.
6. Derosa G, Cicero F, Ciccarelli L, et al. Perindopril and candesartan comparative efficacy and safety in type II diabetic hypertensive patients. J Human Hypertens 2003; 17: 433-5.
7. Ficek J, Kokot F, Chudek J, et al. Influence of antihypertensive treatment with perindopril, pindolol or felodipinon plasma leptin concentration in patients with essential hypertension. Horm Metab Res 2002; 34: 703-8.
8. Fogari R Mugellini A, Zoppi A, et al. Losartan and perindopril effects on plasma plasminogen activator inhibitor-1and fibrinogen in hypertensive type 2 diabetic patients. Am J Hypertens 2002; 15: 316-20.
9. Gabbani S, Giuntoli F, Natali A, et al. Effects of perindopril on carbohydrate and lipoprotein metabolism in essential hypertension. Am J Med 1992; 4(2): 95-7.
10. Ghiadoni L, Magagna A, Versari D, et al. Different effect of antihypertensive drugs on conduit artery endothelial function. Hypertension 2003; 41: 1281-6.
11. Giuntoli F, Huang SS, Wu TC, et al. Combination of an ACE inhibitor and indapamide improves blood pressure control, but attenuates the beneficial effects of ACE inhibition on plasma adiponectin in patients with essential hypertension. Circ J 2009; 73: 2282-7.
12. Guo W, Turlapaty P, Shen Y, et al. Clinical experience with perindopril in patients nonresponsive to previous antihypertensive therapy: a large US community trial. Am J Ther 2004; 11: 199-205.
13. Jandrain B, Herbaut C, Depoorter J-C, et al. Long-term acceptability of perindoprol in type II diabetic patients with hypertension. Am J Med 1992; 92: 91-4.
14. Jerums G, Allen TJ, Campbell DJ, et al. Diabetic Nephropathy Study Group. Long-term renoprotection by perindopril or nifedipine in non-hypertensive patients with type 2 diabetes and microalbuminuria. Diabet Med 2004; 21: 1192-9.
15. Krysiak1 R, Sierant1 M, Marek B, et al. The effect of angiotensin-converting enzyme inhibitors on plasma adipokine levels in normotensive patients with coronary artery disease. Pol J Endocrinol 2010; 61 (3): 280-6.
16. Krysiak1 R, Sierant1 M, Marek B, et al. The effect of perindopril and enalapril on plasma resistin levels in normotensive patients with coronary heart disease. Pol J Endocrinol 2010; 61 (6): 683-90.
17. LI Yuan, WANG Xiao-ming, Yuan-Hong Chen, et al. Effects of perindopril on sICAM-1 and Fas/Apo-1 in peripheral blood of elderly patients with congestive heart failure. Ch J Geriat Cardiovasc and Cerebrovasc Disease 2004; 02: 112-6.
18. Lubel J. Liver Disease and the Renin-angiotensin System: Recent Discoveries and Clinical Implications. Gastroenterol Hepatol 2008; 23(9): 1327-38.
19. Ludwig DS. Childhood Obesity — The Shape of Things to Come. N Engl J Med 2007; 357: 2325.
20. Madej A, Buldak L, Basiak M, et al. The effects of 1 month antihypertensive treatment with perindopril, bisoprolol or both on the ex vivo ability of monocytes to secrete inflammatory cytokines. Int J Clin Pharmacol Ther 2009; 47(11): 686-94.
21. Mathai M, Naik S, Sinclair AJ, et al. Selective reduction in body fat mass and plasma leptin induced by angiotensin-converting enzyme inhibition in rats. International J Obesity 2008; 32: 1576-84.
22. Naik S, Nakamura T, Kawachi K, et al. Effects of ARB or ACE-Inhibitor Administration on Plasma Levels of Aldosterone and Adiponectin in Hypertension. International Heart J 2009; 50: 501-12.
23. PoggiL, Renucci JF, Denolle T. Treatment of essential hypertension in general practice: an open-label study of 47,351 French hypertensive patients treated for one year with perindopril. Can J Cardiol (1994) 10(Suppl. D):21D-24.
24. Sharma AM, Pischon T, Engeli S, et al. Choice of drug treatment for obesity-related hypertension: where is the evidence? J Hypertens 2001; 19: 667-74.
25. Sihm I, Schroeder AP, Aalkjaer C, et al. Normalization of structural cardiovascular changes during antihypertensive treatment with a regimen based on the ACE inhibitor perindopril. Blood Press 1995; 4: 241-8.
26. Toblli1 J, Cao G. Reduced cardiac expression of plasminogen activator inhibitor 1 and transforming growth factor ö1 in obese Zucker rats by perindopril. Heart 2005; 91: 80-6.
27. Tykarski A, Mastej M, Niklas A, et al. Comparation of the effects of the angiotensin II antagonists and ACE inhibitors on renal handling of uric acid in hypertensive patients. Nephrol Dial transplant 1999; 14: A62.
28. Wang XM, Li Y, Li HF, et al. Effects of perindopril on soluble intercellular adhesion molecule-1 in patients with congestive heart failure. Heart 2002; 88: 417.
29. Yasuda G, K Hasegawa K, Kuji T, et al. Perindopril effects on ambulatory blood pressure: relation to sympathetic nervous activity. Am J Hypertens 2004; 17: 14-20.
30. Ying Li, Song Yaoming, Huang Lan, et al. Effects of perindopril and candesartan on left ventricular remodeling and serum ET-1, IL-6 and MMP-9 levels in patients with chronic heart failure. Acta Acad Med Milit Tert 2011; 06: 127-31.
31. Yoshiji H, Kuriyama S, Yoshii J, et al. Angiotensin-II type 1 receptor interaction is a major regulator for liver fibrosis development in rats. Hepatology 2001; 34: 745-50.
32. Yoshiji H, Kuriyama S, Kawata M, et al. The angiotensinI-converting enzyme inhibitor perindopril suppresses tumor growth and angiogenesis: possible role of the vascular endothelial growth factor. Clin Cancer Res 2001; 7: 1073-8.
33. Вотчал Б.Е. Очерки клинической фармакологии. Государственное издательство медицинской литературы. Москва 1963; С. 89
34. Мычка В.Б., Чазова И.Е. Применение периндоприла у больных мягкой умеренной артериальной гипертензией и метаболическим синдромом. Артер гиперт 2002; 8: 36-41.
35. Недогода С.В., Барыкина И.Н., Чаляби Т.А. и др. Ожирение и артериальная гипертензия. Часть II: особенности антигипертензивной терапии при ожирении. Кардиоваск тер профил 2009; 1: 88-98.
Review
For citations:
Nedogoda S.V., Ledyaeva A.A., Chumachok E.V., Tsoma V.V., Mazina G.G., Salasyuk A.S., Barykina I.N. Comparative effectiveness of perindopril and enalapril in patients with arterial hypertension and obesity. Cardiovascular Therapy and Prevention. 2011;10(7):10-17. (In Russ.)
Views:
18571
Email this article 
