| Objective To evaluate the influence of combined treatment by amlodipine(Aml) with valsartan(Val ) on plasma adiponectin (ADPN)and free fatty acids(FFA) in patients with essential hypertension, and investigate the mechanism of them on new onset diabetes.Methods The fifty hypertensive patients from outpatient department whose diastolic pressure equal to or higher than 95 mmHg were selected as treatment group and eighteen normotensive adults were selected as normal control group from physical examination department in the same period. At first, treatment group treated with Aml (5mg/d single blind treatment) for four weeks. At the end of single blind treatment duration thirty four patients with DBP no less than 90 mmHg were enrolled into the double blind treatment and finished the whole trail. They were randomized into two subgroups. One subgroup were treated with Aml (5mg/d) and the other subgroup were treated with Aml plus Val (Aml+Val 5mg/d+80 mg/d) for eight-week treatment. The BP,heart rate,fasting blood glucose, lipids, as well as plasma ADPN and FFA were assayed before and after the four-week single blind treatment and at the end of the double blind treatment. The concentration of plasma ADPN were assayed by enzyme-linked immunosorbent assay (ELISA), the plasma FFA concentration was determinated by biscyclohexanoneoxaIyldih -ydraone chromatometry.Results Firstly, the plasma FFA was significantly higher and the plasma ADPN was lower in hypertensive group than control group. Meanwhile, the fasting TC, TG, VLDL-c, LDL-c and fasting blood glucose were significantly higher in hypertensive group. Secondly, The plasma ADPN level increased significantly(4.62±1.11 vs 5.01±1.23 mg/L,P<0.05), although the FFA level decreased somewhat(645.9±112.3 vs 621.2±123.9μmol/L,NS)after single blind treatment duration. The lipids and fasting boold glucose did not significant change at the same period. Lastly, at the end of the double -blind treatment, the BP of Aml and Aml+Val subgroups were similar (SBP 126.3±10.9 vs 127.2±9.4 mmHg and DBP 84.4±6.9 vs 85.5±6.46 mmHg) and the SBP mean and DBP mean of Aml+Val subgroup were only lower 0.9 mmHg and 1.1 mmHg than those of Aml subgroup respectively. Furthermore the BP value deacresing range of two subgroups were similar too. But the plasma FFA of Aml+Val subgroup decreased significantly(620.1±137.7 vs 548.1±99.3 μmol/L, P<0.01), and the plasma ADPN increased further significantly(5.01±1.23 vs 5.57±1.22 mg/L,P<0.01)in Aml+Val subgroup. However, no significant changes of plasma FFA and ADPN were found in Aml group(FFA 622.4±112.7 vs 607.7±92.0μmol/L,NS and ADPN 5.02±1.27 vs 5.22±1.75 mg/L,NS). The blood lipids and fasting boold glucose did not significantly change in 2 subgroups yet.Conclusion Firstly, the plasma FFA level is higher and the plasma ADPN is lower in hypertensive patients than normotensive adults. Secondly, the four-week amlodipine treatment could significantly increase the level of plasma ADPN in hypertensive patients but it didn't work in plasma FFA of them. Thirdly, at the base of four-week amlodipine treatment, the combination treatment of amlodipine and valsartan could decrease the plasma FFA level and increase plasma adiponectin level further, which suggests that the combination of the these 2 drugs can reduce the disadvantage factors ofβcells and benefit to prevent new onset diabetes in hypertensive patients.
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