Changes in TRG/ApoA-1 ratio, TRG/HDL-C ratio and lipid serum profile after combination therapy with manidipine/delapril in prediabetic hypertensive patients

Type of funding sources: None.

Both manidipine and delapril have been proven to have a neutral effect on lipids. Patients with idiopathic hypertension are being administered with the 30mg hydrochloric delapril and 10mg hydrochloric manidipine formulation. The purpose of this study was to investigate the effect of the fixed combination of delapril/manidipine 30/10mg on lipid and apolipoprotein levels as well as on TRG/ApoA-1 and TRG/HDL-C ratios as indicative markers of insulin resistance, in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-179 mmHg and/or diastolic blood pressure (DBP) 100-109 mmHg) and with prediabetes (IFG/IGT), before and after the 3-month treatment.

53 patients referred to our outpatient clinic for lipid metabolism disorders and met the study’s criteria were included, during the period 2014-2018. In the group of delapril/minidipine there were randomized 30 males and 23 females from whom 12 were smokers and 7 alcohol users). The patients’ BMI was 28.73 [27.73-30.3] and the values of SBP and DBP were: 156 [151-161] και 100 [88-101] mmHg, respectively. The serum lipid and apolipoprotein levels were measured before and after the 3-month treatment.

The resulting variations of SBP and DBP levels, as well as the changes in lipid levels, apolipoprotein levels and TRG/ApoA-1 and TRG/HDL-C ratios are presented on Table 1.

From the sample group it can be observed that the 3-month combination therapy with manidipine/delapril improved statistically significantly both SBP and DBP levels (reduction by -13.58% and -13%, respectively). Concerning serum lipid levels, the combination therapy statistically significantly improved TCHOL, LDL-CHOL, and non-HDL-CHOL levels (decrease by 4.01%, 6.7% and 5.4%, p= 0.009, 0.006 and 0,08 respectively). The changes in apolipoprotein values were small and only ApoB values showed a statistically significant variation. Finally, there wasn’t a statistically significant improvement on neither TRG/ApoA-1 nor TRG/HDL-C ratios.