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M. V. Zunzunegui-Pastor, J. S. Luque-Martin, F. M. Gómez-Trujillo, M. J. Ferreras-Duarte, I. Garcıéa-Caravaca, P-253: Effects of candesartan, metformin and pravastatin combination on cardiovascular risk factors in a poor controled hypertensive population with chronic metabolic syndrome, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Pages 113A–114A, https://doi.org/10.1016/S0895-7061(01)02107-0
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Abstract
Hypertension as a part of the chronic metabolic syndrome has a multiplicative and devastating cardiovascular risk effect that advises an aggressive intervention over all the risk factors in order to preserve the amount and quality of life in this high-risk population. 23 patients with hypertension, type 2 diabetes, dislipemia and central obesity (Chronic Metabolic Syndrome) had macrovascular affectation as consequence of a poor control over their diseases (see below table) secondary to lack of treatment adherence and sub-optimal selection of the available therapeutic options following the JNC-VI, WHO/ISH; ADA recommendations. None of them where receiving ARA-II, biguanides or statins. Medium age was 62,4 years (+/- 9,3), hypertension was known for 9,9 years (+/- 2,36) and diabetes for 8,1 years (+/- 3,2). All received educative interventions by the nurses plus candesartan 16 mgr per day, metformin 850 mgr twice a day and pravastatin 20 mgr per day. The high prevalence of non-compliance with diet, exercise and other healthy non-pharmacological interventions supports the intensive drug therapy in this high-risk patient's subpopulation. Associating candesartan as the second or third antihipertensive drug permits to control the blood pressure fulfilling the ADA, WHO and JNC-VI criteria. The pravastatin and butformin association significatively improves the lipids profile, atherogenic index and the abnormalities of the coagulation/fibrinolytic system that predispose to a procoagulant state.
. | Baseline Std . | Follow-up Std . | t-test . | ||
---|---|---|---|---|---|
HbA1c (%) | 8.57 | 1.93 | 8.21 | 1.78 | n.s. |
BMI | 32.7 | 4.81 | 32.81 | 4.18 | n.s. |
SBP (mm Hg) | 155.78 | 14.36 | 134.06 | 13.56 | 0.0029 |
DBP (mm Hg) | 88.68 | 10.52 | 71.56 | 8.10 | 0.0000 |
Triglycerides (mg/dL) | 155.37 | 66.74 | 140.63 | 54.96 | n.s. |
T-chol (mg/dL) | 252.52 | 40.88 | 215.08 | 26.87 | 0.0300 |
HDL (mg/dL) | 49.05 | 11.61 | 50.38 | 10.77 | 0.0902 |
LDL (mg/dL) | 166.36 | 29.82 | 133.27 | 27.18 | 0.0392 |
T-c/HDL | 5.40 | 1.61 | 4.46 | 0.94 | 0.0062 |
LDL/HDL | 3.60 | 1.42 | 2.83 | 0.92 | 0.0133 |
Fibrinogen (mg/dL) | 383.62 | 76.93 | 335.73 | 52.64 | n.s. |
Leukocytes | 8,426 | 2,074 | 7,090 | 1,385 | 0.0836 |
Platelets 10*3 | 238.4 | 66.4 | 194.5 | 44.1 | 0.0609 |
. | Baseline Std . | Follow-up Std . | t-test . | ||
---|---|---|---|---|---|
HbA1c (%) | 8.57 | 1.93 | 8.21 | 1.78 | n.s. |
BMI | 32.7 | 4.81 | 32.81 | 4.18 | n.s. |
SBP (mm Hg) | 155.78 | 14.36 | 134.06 | 13.56 | 0.0029 |
DBP (mm Hg) | 88.68 | 10.52 | 71.56 | 8.10 | 0.0000 |
Triglycerides (mg/dL) | 155.37 | 66.74 | 140.63 | 54.96 | n.s. |
T-chol (mg/dL) | 252.52 | 40.88 | 215.08 | 26.87 | 0.0300 |
HDL (mg/dL) | 49.05 | 11.61 | 50.38 | 10.77 | 0.0902 |
LDL (mg/dL) | 166.36 | 29.82 | 133.27 | 27.18 | 0.0392 |
T-c/HDL | 5.40 | 1.61 | 4.46 | 0.94 | 0.0062 |
LDL/HDL | 3.60 | 1.42 | 2.83 | 0.92 | 0.0133 |
Fibrinogen (mg/dL) | 383.62 | 76.93 | 335.73 | 52.64 | n.s. |
Leukocytes | 8,426 | 2,074 | 7,090 | 1,385 | 0.0836 |
Platelets 10*3 | 238.4 | 66.4 | 194.5 | 44.1 | 0.0609 |
. | Baseline Std . | Follow-up Std . | t-test . | ||
---|---|---|---|---|---|
HbA1c (%) | 8.57 | 1.93 | 8.21 | 1.78 | n.s. |
BMI | 32.7 | 4.81 | 32.81 | 4.18 | n.s. |
SBP (mm Hg) | 155.78 | 14.36 | 134.06 | 13.56 | 0.0029 |
DBP (mm Hg) | 88.68 | 10.52 | 71.56 | 8.10 | 0.0000 |
Triglycerides (mg/dL) | 155.37 | 66.74 | 140.63 | 54.96 | n.s. |
T-chol (mg/dL) | 252.52 | 40.88 | 215.08 | 26.87 | 0.0300 |
HDL (mg/dL) | 49.05 | 11.61 | 50.38 | 10.77 | 0.0902 |
LDL (mg/dL) | 166.36 | 29.82 | 133.27 | 27.18 | 0.0392 |
T-c/HDL | 5.40 | 1.61 | 4.46 | 0.94 | 0.0062 |
LDL/HDL | 3.60 | 1.42 | 2.83 | 0.92 | 0.0133 |
Fibrinogen (mg/dL) | 383.62 | 76.93 | 335.73 | 52.64 | n.s. |
Leukocytes | 8,426 | 2,074 | 7,090 | 1,385 | 0.0836 |
Platelets 10*3 | 238.4 | 66.4 | 194.5 | 44.1 | 0.0609 |
. | Baseline Std . | Follow-up Std . | t-test . | ||
---|---|---|---|---|---|
HbA1c (%) | 8.57 | 1.93 | 8.21 | 1.78 | n.s. |
BMI | 32.7 | 4.81 | 32.81 | 4.18 | n.s. |
SBP (mm Hg) | 155.78 | 14.36 | 134.06 | 13.56 | 0.0029 |
DBP (mm Hg) | 88.68 | 10.52 | 71.56 | 8.10 | 0.0000 |
Triglycerides (mg/dL) | 155.37 | 66.74 | 140.63 | 54.96 | n.s. |
T-chol (mg/dL) | 252.52 | 40.88 | 215.08 | 26.87 | 0.0300 |
HDL (mg/dL) | 49.05 | 11.61 | 50.38 | 10.77 | 0.0902 |
LDL (mg/dL) | 166.36 | 29.82 | 133.27 | 27.18 | 0.0392 |
T-c/HDL | 5.40 | 1.61 | 4.46 | 0.94 | 0.0062 |
LDL/HDL | 3.60 | 1.42 | 2.83 | 0.92 | 0.0133 |
Fibrinogen (mg/dL) | 383.62 | 76.93 | 335.73 | 52.64 | n.s. |
Leukocytes | 8,426 | 2,074 | 7,090 | 1,385 | 0.0836 |
Platelets 10*3 | 238.4 | 66.4 | 194.5 | 44.1 | 0.0609 |
- obesity
- pravastatin
- hypertension
- pharmacotherapy
- triglycerides
- body mass index procedure
- metabolic syndrome x
- statins
- fibrinogen
- patient compliance
- metformin
- heart disease risk factors
- blood platelets
- biguanides
- diabetes mellitus, type 2
- blood pressure
- diet
- exercise
- high density lipoproteins
- blood coagulation
- follow-up
- hemoglobin a, glycosylated
- leukocytes
- nurses
- world health organization
- lipids
- pharmacology
- quality of life
- candesartan cilexetil
- fibrinolytic system
- coagulation process