Effects of combination treatment with cilnidipine and telmisartan on hypertension, cardiovascular injury, and high blood glucose

Abstract

Polypharmacy is an important strategy for managing high blood pressure (BP). Combination treatment with a Ca2+ channel blocker (CCB) and an angiotensin II type 1 receptor blocker (ARB) can be used for this purpose. If combination therapy had additional beneficial effects such as protection against cardiovascular injury and regulation of blood glucose, it would be an effective tool for managing metabolic syndrome. Thus, this study investigated the effects of combination treatment with the CCB cilnidipine and the ARB telmisartan on hypertension, cardiovascular injury, and hyperglycemia. A telemetry system was used to measure BP and heart rate (HR) in spontaneous hypertensive rats (SHRs). The effectiveness of combination therapy in protecting against cardiovascular injury was examined using a myocardial ischemia/reperfusion (MI/R) system in SHRs and a cuff-placement-induced neointima hyperplasia model in C57BL/6 mice. An oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) were also performed in obese diabetic mice. Combination treatment with a fixed (human equivalent) dose of cilnidipine and telmisartan can effectively lower BP without reflex tachycardia. This combination therapy may also induce cardioprotective effects by increasing the expression of endothelial nitric oxide synthase (eNOS) and vasoprotective effects by inhibiting DNA synthesis in cuff-induced vascular injury. In addition, it may also attenuate high blood glucose levels. The results of this study suggest that combination treatment with cilnidipine and telmisartan can be used as an effective strategy for the treatment of hypertension and related complications.