Navegando por Palavras-chave "Central arterial pressure"

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    Micropartículas e doença cardiovascular hipertensiva: efeitos do tratamento anti-hipertensivo e hipolipemiante em micropartículas circulantes
    (Universidade Federal de São Paulo (UNIFESP), 2018-04-26) Massunaga, Nayara Dantas [UNIFESP]; Fonseca, Francisco Antonio Helfenstein [UNIFESP]; França, Carolina Nunes; http://lattes.cnpq.br/6580677601405775; http://lattes.cnpq.br/2393476657163442; http://lattes.cnpq.br/1470279541149956; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Patients with hypertension on stage 2 are usually treated with a combination of two antihypertensive drugs. However, the combination including a diuretic or a calcium channel blocker may determine different effects on vessels, despite similar decrease on blood pressure. Objectives: This study aimed to compare the effects of amlodipinebased treatment with that obtained by hydrochlorothiazide monotherapy or sequentially combined with valsartan and addition and subsequent withdrawal of rosuvastatin on circulating microparticles. An exploratory analysis was also performed on the effects on central blood pressure parameters and vascular compliance. Methods: Prospective, randomized, openlabel with blinded outcomes study included patients of both sexes on stage 2 hypertension who remained for four weeks on the use of amlodipine (n = 24) or hydrochlorothiazide (n = 22) monotherapy. At the end of this period, blood samples were collected for protocol analyses and blood pressure data were obtained. Three sequential fourweek periods were followed at the end of which the mentioned laboratory and blood pressure parameters were obtained. In the second period valsartan 160 mg was added in both arms of the study, in the third rosuvastatin 20 mg and in the last rosuvastatin was suspended, and the antihypertensive treatment was maintained for four weeks. Monocytic, endothelial and platelet microparticles were quantified by flow cytometry and specific antibodies at the end of each intervention period. Results: Biochemical parameters and peripheral blood pressure were similar between the two groups at the end of treatment as monotherapy, as well as throughout the study. However, central pressure parameters were lower in the anlodipine arm from the addition of valsartan (p = 0.002) and did not change in the hydrochlorothiazide arm. The pulse wave velocity was not changed in both treatment groups. Circulating monocytic microparticles remained unchanged in the amlodipine group, but increased in the hydrochlorothiazide group (p = 0.02). For the circulating endothelial microparticles, a reduction with the hydrochlorothiazide group was observed throughout the study. With regard to circulating platelet microparticles, a greater amount was observed after suspension of rosuvastatin in the anlodipine arm. Conclusions: The choice of combination treatment based on amlodipine or hydrochlorothiazide has different effects on both circulating microparticles and synergism with other drugs. In addition, they show important differences in central hemodynamic parameters. These findings suggest differences in cardiovascular protection.