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Aim. To study the effect of amlodipine on the main indicators of systemic inflammation and its safety in patients with arterial hypertension (HT) in combination with ischemic heart disease (IHD) or diabetes mellitus (DM) type 2. Material and methods. Patients with HT (2-3 degree) associated with IHD or DM type 2 were included into the study. Patients were randomized into main group (n=30) receiving amlodipine 5-10 mg daily in addition to standard therapy (ACE inhibitors, beta-blockers, aspirin, statins, hypoglycemic agents), or into control group (n=30) receiving only standard therapy. Efficacy and safety of the therapy was evaluated by clinical, instrumental and laboratory parameters. Dynamics of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α and C-reactive proteine (CRP) levels were determined to evaluate the activity of systemic inflammation. Treatment duration was 6-8 weeks. Results. Blood pressure reduction by 17.1±5.8/11.4±4.0 mmHg (p<0.05) was revealed in the main group and by 13.6±4.7/8.9±5.3 mm Hg - in the control one. A number of angina pectoris daily episodes decreased from 2.4±0.3 to 1.8±0.2 in the main group and from 2.2±0.2 to 2.0±0.4 in the control group. Angina attacks duration also decreased from 2.3 to 1.25 min in the main group. Significant reduction of IL-6 blood level from 16.6 (5.0; 22.5) to 6.5 (1.6; 12.7) pg/ml (p<0.05) and CRP blood level from 7.45 (2.56; 9.54) to 5.35(3.45; 6.23) mg/l (p<0.05) was observed in the main group (data is presented as median and interquartile range in the bracket). Blood levels of these inflammatory markers did not change significantly in the control group: IL-6 from 19.7 (7.3; 29.6) to 22.5 (13.6; 48.3) pg/ml, CRP from 6.85 (3.85; 8.23) to 7.05 (3.15; 9.12) mg/ l. Treatment tolerability was comparable in the groups.  Conclusion. Amlodipine is effective and safe antihypertensive agent. It reduces systemic pro-inflammation activity , which can promote atherosclerosis progression. Therefore, amlodipine can be recommended as first-line drug for the treatment of HT associated with DM and IHD.

About the Authors

A. A. Tarasov
Volgograd State Medical University
Russian Federation

S. I. Davydov
Volgograd State Medical University
Russian Federation

T. A. Bezborodova
Volgograd State Medical University
Russian Federation

M. A. Gordeeva
Volgograd State Medical University
Russian Federation

A. R. Babaeva
Volgograd State Medical University
Russian Federation


1. Babaeva A.R., Tarasov A.A., Bezborodova T.A., Zakhar'ina O.A. The conception of a systemic inflammation at pathogenesis of the diabetic angiopathy. Vestnik Volgogradskogo gosudarstvennogo meditsinskogo universiteta 2010; 1 (33): 3-8. Russian (Бабаева А.Р., Тарасов А.А., Безбородова Т.А., Захарьина О.А. Концепция системного воспаления в патогенезе диабетической ангиопатии. Вестник Волгоградского государственного медицинского университета 2010; 1 (33): 3-8).

2. Rjabicheva T.G., Varaksin N.A., Timofeeva N.V. et al. Comparison of kits for the determination of interleukin-1beta and interleukin-6 two different manufacturers. Citokiny i vospalenie 2007; 2: 70-72. Russian (Рябичева Т.Г., Вараксин Н.А., Тимофеева Н.В. и др. Цитокины и воспаление 2007; 2: 70-72).

3. Berkels R., Taubert D., Bartels H., Breitenbach T., Klaus W., Roesen R. Amlodipine increases endothelial nitric oxide by dual mechanismus. Pharmacology 2004; 70:39-45.

4. Cominacini L., Pasini A.F., Pastorino A.M, et al. Comparative effects of different dihydropyridines on the expression of adhession molecules induced by TNF-alpha on endothelial cells. J Hypertens 1999;17:1837-41.

5. Cominacini L., Garbin U., Fratta Pacini A. et al. Lacidipine inhibits the activation of the transcription factor NF-kappaB and the expression of adhesion molecules induced by pro-oxidant signals on endothelial cells. J Hypertens 1997;15:1633-40.

6. Ding Y., Vaziri N.D. Nifedipine and Diltiazem but Not Verapamil Up-Regulate Endothelial Nitric-Oxide Synthase Expression. J Pharmacol Exp Ther 2000; 292: 606-609.

7. Luscher T., Wenzel R., Moreau P., Takase H. Vascular protective effects of ACE inhibitors and calcium antagonists: Theoretical basis for a combination therapy in hypertension and other cardiovascular diseases. Cardiovasc Drugs Ther 1995; 9: 509-523.

8. Mason R.P., Mak I.T., Trumbore M.W., Mason P.E. Antioxidant properties of calcium antagonists related to membrane biophysical interactions. Am J Cardiol 1999;84:16L-22.


For citations:

Tarasov A.A., Davydov S.I., Bezborodova T.A., Gordeeva M.A., Babaeva A.R. AMLODIPINE IN CORRECTION OF HIGH RISK ARTERIAL HYPERTENSION: FOCUS ON MECHANISMS OF INFLAMMATION. Rational Pharmacotherapy in Cardiology. 2011;7(5):574-578. (In Russ.)

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