Additive beneficial effects of fenofibrate combined with candesartan in the treatment of hypertriglyceridemic hypertensive patients.

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Koh KK, Quon MJ, Han SH, Chung WJ, Ahn JY, Kim JA, Lee Y, Shin EK

Additive beneficial effects of fenofibrate combined with candesartan in the treatment of hypertriglyceridemic hypertensive patients.

Diabetes Care. 2006 Feb;29(2):195-201.

PubMed ID

16443859 [ View in PubMed

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Abstract

OBJECTIVE: Mechanisms underlying fibric acid and angiotensin II type 1 receptor blocker therapies differ. Signaling from peroxisome proliferator-activated receptor alpha may cross-talk with the angiotensin II system. We investigated vascular and metabolic responses to these therapies either alone or in combination in hypertriglyceridemic hypertensive patients. RESEARCH DESIGN AND METHODS: This was a randomized, double-blind, placebo-controlled, cross-over trial with three treatment arms (each 2 months) and two washout periods (each 2 months). Forty-four patients were given 200 mg fenofibrate and placebo, 200 mg fenofibrate and 16 mg candesartan, or 16 mg candesartan and placebo daily during each treatment period. RESULTS: Fenofibrate, combined therapy, or candesartan therapy significantly reduced blood pressure. However, combined therapy significantly reduced blood pressure more than fenofibrate or candesartan alone (P < 0.001 by ANOVA). When compared with candesartan, fenofibrate or combined therapy significantly improved the lipoprotein profile. All three treatment arms significantly improved flow-mediated dilator response to hyperemia. Combined therapy significantly decreased plasma malondialdehyde, high-sensitivity C-reactive protein, and soluble CD40L levels relative to baseline measurements. Importantly, these parameters were changed to a greater extent with combined therapy when compared with monotherapy (P < 0.001, P = 0.002, P = 0.050, and P = 0.032 by ANOVA, respectively). Fenofibrate, combined therapy, and candesartan significantly increased plasma adiponectin levels and insulin sensitivity relative to baseline measurements. However, the magnitude of these increases were not significantly different among the three therapies (P = 0.246 and P = 0.153 by ANOVA, respectively). CONCLUSIONS: Fenofibrate combined with candesartan improves endothelial function and reduces inflammatory markers to a greater extent than monotherapy in hypertriglyceridemic hypertensive patients.

DrugBank Data that Cites this Article

Pharmaco-proteomics

Drug	Drug Groups	Gene	Gene ID	Change	Interaction	Chromosome
Candesartan cilexetil	Approved	CD40LG	959	decreased	candesartan results in decreased expression of CD40LG protein	Xq26.3
Fenofibrate	Approved	CD40LG	959	decreased	Fenofibrate results in decreased expression of CD40LG protein	Xq26.3
Candesartan cilexetil	Approved	ADIPOQ	9370	increased	candesartan results in increased expression of ADIPOQ protein	3q27.3
Fenofibrate	Approved	ADIPOQ	9370	increased	Fenofibrate results in increased expression of ADIPOQ protein	3q27.3
Candesartan cilexetil	Approved	CRP	1401	decreased	candesartan results in decreased expression of CRP protein	1q23.2
Fenofibrate	Approved	CRP	1401	decreased	Fenofibrate results in decreased expression of CRP protein	1q23.2
Fenofibrate	Approved	CRP	1401	decreased	Fenofibrate results in decreased expression of CRP protein	1q23.2