Endocrine Abstracts

Background: Impaired circadian blood pressure (BP) variation is a frequent phenomenon in hypertensive type 2 diabetic (T2DM) patients (pts), and is considered a risk factor for development of cardiovascular complication. The aim - to assess the effect of Lacidipine on left ventricular mass (LVM) and BP in hypertensive T2DM pts.

Materials and methods: Totally 32 T2DM pts with mild-to-moderate hypertension (20 m/12 f, mean age 57±9.6 yrs) were allocated to treatment with 4 mg Lacidipine for 3 months. 24-hour ECG; ambulatory BP monitoring (ABPM); echocardiography; plasma lipid, HbA1c and microalbuminuria were performed at baseline and the end of the study.

Results: Mean 24-hour systolic (SBP) and diastolic (DBP) BP were reduced with Lacidipine (151.1±12.3 / 91.8 ±10.9 vs 133.7±11.4 / 82.1± 9.2 mmHg; P=0.000). Lacidipine reduced awake (152.5±14.3/ 92.6±12.4 vs 134.8±13.8/83.9±9.9 mmHg; P=0.000, P=0.004 respectively), sleep (140.4±12.7/83.2±9.4 vs 125.8±9.7/75.5±10.3 mmHg, P=0.000; P=0.003 respectively), early morning (146.6±14.3/ 90.1±8.7 vs 137.4±12.3/82.3±7.6 mmHg, P=0.008; P=0.000 respectively) SBP and DBP. According to first ABPM data 19 out of 32 pts were non-dippers. At the end of the treatment 15 pts (78.9%) became dippers. Lacidipine reduced LVM (244.7±27.3 vs 231.8±21.3 g; P=0.039), it was due to LVM reduction in pts with elevated baseline LVM; and frequency of silent myocardial ischemia episodes according to Holter ESG data. Heart rate was not altered. Lipids, HbA1c, microalbuminuria did not change significantly.

Conclusion: Treatment with Lacidipine 4 mg daily for 3 months effectively controls BP in mild-to-moderate hypertensive T2DM pts, reduces 24-hour, awake, sleeping and early morning BP, LVM and frequency of silent myocardial ischemia episodes and does not cause disorders of cardiac rhythm, glucose and lipid metabolisms. Thus, it may be indicated for use in T2DM pts with mild-to-moderate hypertension.