EFFECTS OF ANGIOTENSIN RECEPTOR BLOCKER AZILSARTAN IN ARTERIAL HYPERTENSION COMBINED WITH TYPE II DIABETES MELLITUS

Abstract

Objective: Arterial Hypertension (AH) with type II Diabetes Mellitus (DM II) is characterized by diminished myocardial compliance with diastolic dysfunction and impaired left ventricular filling. Angiotenzin receptors blocker (ARB) Azilsartan (Az) is antihypertensive drug in AH combined with DM II for good tolerance and metabolic neutrality. Az in AH patients with DM II is unexplored in view of influence on cardiac systolic and diastolic parameters. The interrelation between long-term Az treatment and basic metabolism lipid, carbohydrate indices alterations in AH coupled with DM II is disputable. The purpose of study was evaluation of ARB Az's antihypertensive, hemodynamic and metabolic actions in AH patients with DM II. Design and method: 72 diagnosed I-II WHO classification AH patients without coronary artery disease and congestive heart failure signs with DM II were examined (46 male, 26 female, 42–63 aged, mean age 52+/-2,1 years old, body mass index 32+/-1,8 kg/m2, systolic and diastolic blood pressure (SBP,DBP) range 145/90-179,109 mm Hg, mean blood pressure (MBP) 120+/-3,1 mm Hg. Az was administered once daily 40–80 mg in addition to basic management of DM II. Results: Az significantly reduced SBP 169+/-5.3 vs 148+/-5.1 mm Hg, diminution -12.4% (p<0.02), DBP 104+/-2.6 mm Hg vs 91+/-2.8 mm Hg, diminution-12.6% (p < 0.02), MBP 120+/-3.1 mm Hg vs 106+/-4.4 mm Hg, diminution 11.7% (p < 0.02). Early diastolic filling flow velocity (Peak E) increased significantly 0.56+/-0.033 vs 0.79+/-0.048 m/sec, augmentation+28.9% (p < 0.02). After 4 weeks SBP, DBP, MBP significantly decreased (p < 0.02), 12-weeks management resulted in BP reduction (p < 0.01). No negative changes of carbohydrate, lipid metabolism indices and GFR observed, moreover 12-weeks Az treatment had a trend to some improvement of blood and urine glucose level, lipids and lipoprotein fractions. Conclusions: Az in I-II AH patients with DM II resulted in antihypertensive effect, left ventricular systolic and diastolic performance indices improved. Study didn’t reveal any negative changes of metabolism and GFR. Metabolism indices improvement was marked probably on account of Atherosclerosis prevention actions. Az improves systolic performance and diastolic compliance in AH with DM II, positively affects on metabolism indices. Long-term Az treatment in AH combined with DM II should explored further.