Long-Term Combination Therapy with an ACE Inhibitor, Captopril, and an HMG-CoA Reductase Inhibitor, Pravastatin, Is Beneficial for Hypercholesterolemic Hypertensives: an Observational Study

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  • an Observational Study

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Objective: Lowering blood pressure (BP), and improving lipid and glucose metabolism are the most important factors in preventing cardiovascular events in hypertensive patients with dyslipidemia. This study was conducted to investigate the effects of long-term combination therapy with an ACE inhibitor, captopril, and an HMG-CoA reductase inhibitor, pravastatin, on hemodynamics, and lipid and glucose metabolism in hypertensives with hypercholesterolemia.<BR>Methods: After a 2-month (M) placebo-run-in period, hypertensive patients with hypercholesterolemia (total cholesterol [TC]>6.21mmol/L) were recruited for the study. They were treated with captopril for 6 M, and then pravastatin was added for the following 18 M. BP and serum lipid and fasting plasma glucose (FPG) were determined during the periods of placebo-run-in, captopril monotherapy, and the combination therapy.<BR>Results: Two of 24 participants dropped out from the study. Thus, data were analyzed in 22 participants, and 11 of them had glucose intolerance. Both systolic and diastolic BP were significantly reduced from 169.0/100.9 mmHg to 145.5/83.8 mmHg without changes in heart rate by captopril monotherapy, and those effects were maintained during the combination therapy. After 18 M of the combination therapy, serum lipid levels were significantly reduced by 13.9% in TC (baseline 6.67mmol/L), 13.9% in triglycerides (2.15mmol/L), and 19.9% in LDL-C (4.47mmol/L), while HDL-C was increased from 1.11 to 1.29mmol/L. FPG and HbA1c levels were significantly reduced from 6.08 to 5.47mmol/L and 6.8 to 6.2%.<BR>Conclusion: These results suggest that long-term combination therapy with captopril and pravastatin is beneficial for hypertensive patients with hyperlipidemia regardless of whether they have glucose intolerance.

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  • 臨床薬理

    臨床薬理 35 (5), 257-262, 2004

    一般社団法人 日本臨床薬理学会

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