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Effects of combination treatment with cilnidipine and telmisartan on hypertension, cardiovascular injury, and high blood glucose

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Abstract

Purpose

Polypharmacy is an important strategy for managing high blood pressure (BP). Combination treatment with a Ca2+ channel blocker (CCB) and an angiotensin II type 1 receptor blocker (ARB) can be used for this purpose. If combination therapy had additional beneficial effects such as protection against cardiovascular injury and regulation of blood glucose, it would be an effective tool for managing metabolic syndrome. Thus, this study investigated the effects of combination treatment with the CCB cilnidipine and the ARB telmisartan on hypertension, cardiovascular injury, and hyperglycemia.

Methods

A telemetry system was used to measure BP and heart rate (HR) in spontaneous hypertensive rats (SHRs). The effectiveness of combination therapy in protecting against cardiovascular injury was examined using a myocardial ischemia/reperfusion (MI/R) system in SHRs and a cuff-placement-induced neointima hyperplasia model in C57BL/6 mice. An oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) were also performed in obese diabetic mice.

Results

Combination treatment with a fixed (human equivalent) dose of cilnidipine and telmisartan can effectively lower BP without reflex tachycardia. This combination therapy may also induce cardioprotective effects by increasing the expression of endothelial nitric oxide synthase (eNOS) and vasoprotective effects by inhibiting DNA synthesis in cuff-induced vascular injury. In addition, it may also attenuate high blood glucose levels.

Conclusion

The results of this study suggest that combination treatment with cilnidipine and telmisartan can be used as an effective strategy for the treatment of hypertension and related complications.

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Acknowledgements

This study was financially supported by the research fund of Chungnam National University (2018).

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Authors and Affiliations

  1. Department of Pharmacology, Chungnam National University College of Pharmacy, 99 Daehak-ro (St.), Yuseong-gu, Daejeon, 34134, Republic of Korea

    Jun-Hwan Jo, Do-Hyung Lee, Joo-Hui Han, Miji Lee, Keun-Woo Jang & Chang-Seon Myung

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  1. Jun-Hwan Jo
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  2. Do-Hyung Lee
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  3. Joo-Hui Han
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  4. Miji Lee
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Correspondence to Chang-Seon Myung.

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Conflict of interest

The authors (J.-H. Jo, D.-H. Lee, J.-H. Han, M. Lee, K.-W. Jang, and C.-S. Myung) declare that they have no conflict of interest.

Human and animal rights

This work complies with all ethical standards. Animal experiments were approved by the Chungnam National University Animal Care and Use Committee (2009-2-19).

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Jo, JH., Lee, DH., Han, JH. et al. Effects of combination treatment with cilnidipine and telmisartan on hypertension, cardiovascular injury, and high blood glucose. J. Pharm. Investig. 51, 337–346 (2021). https://doi.org/10.1007/s40005-021-00522-2

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  • DOI: https://doi.org/10.1007/s40005-021-00522-2

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