Key result
Losartan lowers BP but fails to alter oxidant and antioxidant systems in hypertensive T2D patients.
Why the study?
Antihypertensive agents can improve oxidative stress, but the effects of losartan alone versus combined with cilazapril or carvedilol on oxidative stress and antioxidants in hypertensive type 2 diabetic patients required evaluation.
Do different antihypertensive therapy approaches (losartan alone vs combined with cilazapril or carvedilol) improve oxidative stress and antioxidant systems in hypertensive type 2 diabetic patients?
RCT (n=56)
Open-label
Sequential randomization
No
Do different antihypertensive therapy approaches (losartan alone vs combined with cilazapril or carvedilol) improve oxidative stress and antioxidant systems in hypertensive type 2 diabetic patients?
p-value: p=>0.05
Short-term antihypertensive therapy with losartan alone or combined with cilazapril or carvedilol effectively lowers blood pressure but does not significantly alter oxidant and antioxidant systems in hypertensive type 2 diabetic patients.
Losartan regimens lower BP without short-term redox effects in hypertensive T2DM; confirms dissociation between BP control and oxidative balance.
A relationship between endothelial dysfunction and oxidative stress has been shown in the pathogenesis of diabetes and/or hypertension. Antihypertensive drugs (angiotensin-converting enzyme inhibitors [ACEi], angiotensin II type 1 receptor blockers [ARB], and third-generation beta-blockers) can improve oxidative stress. This study evaluated the effects of losartan (ARB) treatment alone and combined with cilazapril (ACEi) or carvedilol on oxidative stress and antioxidants in hypertensive type 2 diabetic patients. Thirty of 56 patients completed the study. All patients received 50 mg losartan daily for 6 weeks, then were randomised into three groups for 6 weeks. In the first group, losartan was increased to 100 mg/day, and in the second and third groups, carvedilol or cilazapril was added to losartan 50 mg/day treatment, respectively. Apolipoprotein B malondialdehyde (basal and Δ-MDA), serum paraoxonase (PON) and arylesterase (AE), erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (Gpx) parameters were studied. The characteristics of the three groups were comparable (p>0.05). Blood pressure (BP) decreased significantly in all three groups before and after randomisation in the six-week periods. The largest BP decrease was seen in the ARB+ACEi group (systolic BP: 16.5±7.4 mmHg, diastolic BP: 10.5±2.8 mmHg), and the smallest decrease was seen in the high-dose ARB group (systolic BP: 9±6.1 mmHg, diastolic BP: 3±4.8 mmHg). Throughout the study, no significant changes were detected in basal and Δ-MDA levels and SOD, Gpx, PON and AE activities in inter- and intra-group comparisons. Our observations showed that different antihypertensive therapy approaches effectively lowered BP in hypertensive type 2 diabetics but did not affect oxidant and antioxidant systems in the short term.
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Ersoy et al. (2024) conducted an RCT in Hypertension and Type 2 Diabetes Mellitus (n=56). Losartan alone or combined with carvedilol or cilazapril vs. Active comparators (comparison between the three regimens) was evaluated on Oxidant and antioxidant system parameters (basal and Δ-MDA, SOD, Gpx, PON, AE) (p=>0.05). Losartan alone or combined with cilazapril or carvedilol effectively lowered blood pressure but did not significantly affect oxidant and antioxidant systems over a 12-week period in hypertensive type 2 diabetic patients.
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