Efeitos da vildagliptina na função endotelial, rigidez arterial e na pressão arterial em pacientes com diabetes mellitus do tipo 2 e hipertensão arterial

• Ano de defesa: 2017
• Autor(a) principal: Martin, Luciana Neves Cosenso
• Orientador(a): Martin, José Fernando Vilela
• Banca de defesa: Moreno Júnior, Heitor, Chagas, Antônio Carlos Palandri, Pires, Antônio Carlos, Toledo, Juan Carlos Yugar
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Faculdade de Medicina de São José do Rio Preto
• Programa de Pós-Graduação: Programa de Pós-Graduação em Ciências da Saúde::-6954410853678806574::500
• Departamento: Faculdade 1::Departamento 1::306626487509624506::500
• País: Brasil
• Palavras-chave em Português: Diabetes Mellitus Tipo II; Hipertensão; Endotélio Vascular
• Palavras-chave em Inglês: Type II Diabetes Mellitus; Hypertension; Vascular Endothelium
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::8765449414823306929::600
• Link de acesso: http://bdtd.famerp.br/handle/tede/417

Several trials have shown that dipeptidyl peptidase-4 (DPP-4) inhibitors, used to treat patients with diabetes mellitus type 2 (T2DM), improve endothelial function. Objectives: The current study investigated the effects of vildagliptin, a DPP-4 inhibitor, compared to glibenclamide on endothelial function and arterial stiffness (AS) in patients with T2DM and hypertension (HT). Casuistics and Methods: This trial was a prospective randomized, open label, controlled by drug. Fifty patients aged over 35 years with T2DM and hypertension, without cardiovascular disease, were randomly allocated to treatment with vildagliptin (n=25) or glibenclamide (n=25). Both groups used metformin. A 24-h non-invasive ambulatory blood pressure monitoring and assessment of endothelial function were performed before and after 12 weeks of treatment. Endothelial function was evaluated by peripheral artery tonometry (Endo- PAT 2000), measuring the reactive hyperemia index (RHI) and arterial stiffness. AS was also evaluated by augmentation index (Aix@75), pulse wave velocity (PWV) and central systolic blood pressure (cSBP) parameters with a portable compact digital BP recorder Mobil-O-Graph® 24-hour PWA monitor. The primary study outcome was change in the RHI after vildagliptin vs. glibenclamide treatment. Results: There were no changes in RHI in the vildalgliptin group (before 2.348 ± 0.5868; after 2.2408 ± 0.6019, P = 0.742) or in the glibenclamide group (before 2.3636 ± 0.5163; after 2.3375 ± 0.4996, P = 0.950) and no difference between groups (P = 0.5479). There was no difference between vildagliptin and glibenclamide treatment in AIx@75 PAT (P = 0.696), in 24-hs: cSBP (P = 0.274) and in PWV (P = 0.324). Conclusions: Vildagliptin in patients with T2DM and HT did not change endothelial function and AS during 12 weeks. Thus, this drug has a neutral effect on vascular function, providing its effectiveness for the treatment of patients with cardiovascular disease.