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The Effect of Fosinopril and Lercanidipine on ...

CardiologieThe Effect of Fosinopril and Lercanidipine on Oxidative Stress in Elderly Patients with Isolated Systolic Hypertension


Articol din publicatia Timisoara Medical Journal nr. 3/2005
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Ioana Dana Alexa, Adrian Covic, Florentina Palade, Larisa Panaghiu, Paul Gusbeth-Tatomir, Gabriel Ungureanu
Department of Internal Medicine- Nephrology, Parhon University Hospital, University of Medicine and Pharmacy Gr. T. Popa Iasi, Romania

Background: High oxidative stress appears to be related to high cardiovascular risk particularly in populations like elderly patients with isolated systolic hypertension (ISH). Few data are available on the effect of angiotensin-converting enzyme inhibitors (ACEI) and calcium-channel blockers (CCB) in this population. We aimed to examine the effect of treatment with fosinopril and/or lercanidipine on several parameters of oxidative stress as proatherogenic factors in elderly patients with ISH. Methods: A prospective study of 168 patients aged ≥ 65 years admitted in our clinic in 2003 for ISH (systolic BP ≥ 160 mmHg and diastolic BP

Results: There was no difference in demographics and in BP levels between the four groups. Fosinopril significantly increased the GSH complex: GSH (μg/ml) from 1.56 0.09 to 2.04 0.13 (+ 25%) at 6 weeks and to 2.68 0.17 (+ 56%) at 12 weeks and GSH-Px (μmol GSSG/ml/min) from 0.167 0.036 to 0.221 0.039 (+ 30%) at 6 weeks and to 0.304 0.023 (+ 75%) at 12 weeks. Lercanidipine significantly increased SOD activity (U/Ht) from 0.338 0.009 to 0.551 0.012 (+ 48%) at 6 weeks and to 0.724 0.005 (+ 70%) at 12 weeks. The association of both drugs increased all three antioxidants: GSH (μg/ml) from 1.58 0.008 to 2.385 0.14 (+ 50%) at 6 weeks and to 2.68 0.17 (+ 62%) at 12 weeks, GSH-Px (μmol GSSG/ml/min) from 0.148 0.031 to 0.224 0.045 (+ 52%) at 6 weeks and to 0.298 0.018 (+ 78%) at 12 weeks, SOD (U/Ht) from 0.402 0.011 to 0.590 0.009 (+ 49%) at 6 weeks and to 0.776 0.008 (+ 72%) at 12 weeks and decreased serum level of LP (μmol MDA/ml) from 3.26 0.02 to 2.64 0.036 (- 49%) at 6 weeks and to 1.96 0.028 (- 64%) at 12 weeks. These results suggested the additive effect of the association of ACEI and CCB. There were no significant modifications of oxidative stress markers in the control group.

Conclusions: Our results support the hypothesis that fosinopril and lercanidipine increase antioxidant activity in elderly patients, our study being one of the few that studied this effect in elderly. The mechanisms underlying these effects remain unknown.
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