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Acta Diabetologica
Published in: Acta Diabetologica 12/2018

01-12-2018 | Original Article

Effect of vildagliptin versus glibenclamide on endothelial function and arterial stiffness in patients with type 2 diabetes and hypertension: a randomized controlled trial

Authors: Luciana Neves Cosenso-Martin, Luiz Tadeu Giollo-Júnior, Letícia Aparecida Barufi Fernandes, Cláudia Bernardi Cesarino, Marcelo Arruda Nakazone, Maurício de Nassau Machado, Juan Carlos Yugar-Toledo, José Fernando Vilela-Martin

Published in: Acta Diabetologica | Issue 12/2018

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Abstract

Aims

Several trials have reported that dipeptidyl peptidase-4 (DPP-4) inhibitors, used to treat type 2 diabetes (T2DM), improve endothelial function. The current study investigated the effects of vildagliptin, a DPP-4 inhibitor, compared to glibenclamide on endothelial function, arterial stiffness, and blood pressure in patients with T2DM and hypertension.

Methods

Patients aged over 35 years with T2DM and hypertension, but without cardiovascular disease, were randomly allocated to treatment with vildagliptin (n = 25) or glibenclamide (n = 25). Both groups took metformin. Endothelial function was evaluated by peripheral artery tonometry (Endo-PAT 2000) to calculate the reactive hyperemia index (RHI) and arterial stiffness. Primary outcome was change in the RHI after 12 weeks of treatment. Twenty-four-hour non-invasive ambulatory blood pressure monitoring was performed using a Mobil-O-Graph® 24-h PWA monitor. Arterial stiffness was assessed using the augmentation index corrected for 75 bpm (AIx75), pulse wave velocity (PWV) and central systolic blood pressure (cSBP).

Results

There were no changes in the RHI in the vildagliptin group (before 2.35 ± 0.59; after 2.24 ± 0.60; p value = NS) or in the glibenclamide group (before 2.36 ± 0.52; after 2.34 ± 0.50; p value = NS), with no differences between groups (p value = NS). There was also no difference between vildagliptin and glibenclamide treatment in respect to AIx75 (p value = NS), cSBP (p value = NS) or PWV (p value = NS).

Conclusions

Vildagliptin and glibenclamide similarly do not change the endothelial function and arterial stiffness after 12 weeks of treatment in diabetic and hypertensive patients without cardiovascular disease. Thus, vildagliptin has a neutral effect on vascular function.

Trial registration

ClinicalTrials.gov: NCT02145611, registered on 11 Jun 2013.
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Metadata
Title
Effect of vildagliptin versus glibenclamide on endothelial function and arterial stiffness in patients with type 2 diabetes and hypertension: a randomized controlled trial
Authors
Luciana Neves Cosenso-Martin
Luiz Tadeu Giollo-Júnior
Letícia Aparecida Barufi Fernandes
Cláudia Bernardi Cesarino
Marcelo Arruda Nakazone
Maurício de Nassau Machado
Juan Carlos Yugar-Toledo
José Fernando Vilela-Martin
Publication date
01-12-2018
Publisher
Springer Milan
Published in
Acta Diabetologica / Issue 12/2018
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-018-1204-1

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