PMID- 23635096
OWN - NLM
STAT- MEDLINE
DCOM- 20131126
LR  - 20221207
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 12
DP  - 2013 May 2
TI  - Effects of co-administration of candesartan with pioglitazone on inflammatory 
      parameters in hypertensive patients with type 2 diabetes mellitus: a preliminary 
      report.
PG  - 71
LID - 10.1186/1475-2840-12-71 [doi]
AB  - BACKGROUND: Angiotensin receptor blockers (ARBs) are reported to provide direct 
      protection to many organs by controlling inflammation and decreasing oxidant 
      stress. Pioglitazone, an anti-diabetic agent that improves insulin resistance, 
      was also reported to decrease inflammation and protect against atherosclerosis. 
      This study aimed to evaluate the utility of combination therapy with both 
      medicines from the viewpoint of anti-inflammatory effects. METHODS: We 
      administered candesartan (12 mg daily) and pioglitazone (15 mg daily) 
      simultaneously for 6 months to hypertensive patients with type 2 diabetes 
      mellitus (T2DM) and evaluated whether there were improvements in the serum 
      inflammatory parameters of high-molecular-weight adiponectin (HMW-ADN), 
      plasminogen activator inhibitor-1 (PAI-1), highly sensitive C-reactive protein 
      (Hs-CRP), vascular cell adhesion molecule-1 (VCAM-1), and 
      urinary-8-hydroxydeoxyguanosine (U-8-OHdG). We then analyzed the relationship 
      between the degree of reductions in blood pressure and HbA1c values and 
      improvements in inflammatory factors. Furthermore, we analyzed the relationship 
      between pulse pressure and the degree of lowering of HbA1c and improvements in 
      inflammatory factors. Finally, we examined predictive factors in patients who 
      received benefits from the co-administration of candesartan with pioglitazone 
      from the viewpoint of inflammatory factors. RESULTS: After 6 months of treatment, 
      in all patients significant improvements from baseline values were observed in 
      HMW-ADN and PAI-1 but not in VCAM-1, Hs-CRP, and U-8-OHdG. Changes in HbA1c were 
      significantly correlated with changes in HMW-ADN and PAI-1 in all patients, but 
      changes in blood pressure were not correlated with any of the parameters 
      examined. Correlation and multilinear regression analyses were performed to 
      determine which factors could best predict changes in HbA1c. Interestingly, we 
      found a significant positive correlation of pulse pressure values at baseline 
      with changes in HbA1c. CONCLUSIONS: Our data suggest that the pulse pressure 
      value at baseline is a key predictive factor of changes in HbA1c. 
      Co-administration of candesartan with pioglitazone, which have anti-inflammatory 
      (changes in HMW-ADN and PAI-1) effects and protective effects on organs, could be 
      an effective therapeutic strategy for treating hypertensive patients with type 2 
      diabetes mellitus. TRIAL REGISTRATION: UMIN-CTR: UMIN000010142.
FAU - Suzuki, Hirofumi
AU  - Suzuki H
AD  - Department of Internal Medicine, Division of Diabetes, Metabolism and 
      Endocrinology, Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, 
      Minato-ku, Tokyo 105-8461, Japan.
FAU - Sakamoto, Masaya
AU  - Sakamoto M
FAU - Hayashi, Takeshi
AU  - Hayashi T
FAU - Iuchi, Hiroyuki
AU  - Iuchi H
FAU - Ohashi, Kennosuke
AU  - Ohashi K
FAU - Isaka, Tsuyoshi
AU  - Isaka T
FAU - Sakamoto, Noriko
AU  - Sakamoto N
FAU - Kayama, Yosuke
AU  - Kayama Y
FAU - Tojo, Katsuyoshi
AU  - Tojo K
FAU - Yoshimura, Michihiro
AU  - Yoshimura M
FAU - Utsunomiya, Kazunori
AU  - Utsunomiya K
LA  - eng
PT  - Journal Article
DEP - 20130502
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
RN  - 0 (ADIPOQ protein, human)
RN  - 0 (Adiponectin)
RN  - 0 (Angiotensin II Type 1 Receptor Blockers)
RN  - 0 (Benzimidazoles)
RN  - 0 (Biphenyl Compounds)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Plasminogen Activator Inhibitor 1)
RN  - 0 (SERPINE1 protein, human)
RN  - 0 (Tetrazoles)
RN  - 0 (Thiazolidinediones)
RN  - 0 (Vascular Cell Adhesion Molecule-1)
RN  - 0 (hemoglobin A1c protein, human)
RN  - 12133JR80S (Guanosine)
RN  - 3868-31-3 (8-hydroxyguanosine)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - S8Q36MD2XX (candesartan)
RN  - X4OV71U42S (Pioglitazone)
SB  - IM
MH  - Adiponectin/immunology
MH  - Adult
MH  - Aged
MH  - Angiotensin II Type 1 Receptor Blockers/*therapeutic use
MH  - Benzimidazoles/*therapeutic use
MH  - Biphenyl Compounds
MH  - Blood Pressure
MH  - C-Reactive Protein/immunology
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy/immunology
MH  - Drug Therapy, Combination
MH  - Female
MH  - Glycated Hemoglobin
MH  - Guanosine/analogs & derivatives/urine
MH  - Humans
MH  - Hypertension/complications/*drug therapy/immunology
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Pioglitazone
MH  - Plasminogen Activator Inhibitor 1/immunology
MH  - Prospective Studies
MH  - Tetrazoles/*therapeutic use
MH  - Thiazolidinediones/*therapeutic use
MH  - Treatment Outcome
MH  - Vascular Cell Adhesion Molecule-1/immunology
PMC - PMC3663745
EDAT- 2013/05/03 06:00
MHDA- 2013/12/16 06:00
PMCR- 2013/05/02
CRDT- 2013/05/03 06:00
PHST- 2013/03/21 00:00 [received]
PHST- 2013/04/19 00:00 [accepted]
PHST- 2013/05/03 06:00 [entrez]
PHST- 2013/05/03 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
PHST- 2013/05/02 00:00 [pmc-release]
AID - 1475-2840-12-71 [pii]
AID - 10.1186/1475-2840-12-71 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2013 May 2;12:71. doi: 10.1186/1475-2840-12-71.