Effect Observation Of Fenofibrate Combined With Candesartan In The Treatment Of Hypertriglyceridemic Hypertensive Patients

[Objective]We investigated blood pressure,total cholesterol,triglycerides,LDL cholesterol,HDL cholesterol,C-reactive protein and flow-mediated dilation to these therapies either alone or in combination of fenofibrate and candesartan in hypertriglyceridemic hypertensive patients.[Methods]This was a randomized,placebo-controlled trial.Forty-six patients were randomly divided into three groups:300 mg fenofibrate(100mgtid)+placebo;8 mg candesartan+placebo;and 300 mg fenofibrate(100mgtid)+8mg candesartan daily during each treatment period.Blood pressure measured in the right arm in the sitting position using a standard sphygmomanometer with appropriate-sized cuff was recorded as the mean of two successive readings.Assays for lipids,glucose and C-reactive protein were performed with the kits and equipments produced in Japanese.Imaging studies of the right brachial artery were performed using a HP5500 ultrasound machine(Philips, America) equipped with a 10-MHz linear array transducer,based on a previously published technique.[Results]1,Combined therapy,or candesartan all significantly reduced systolic and diastolic blood pressure after 2 months administration when compared with baseline(all P＜0.05). However,combined therapy significantly reduced blood pressure more than fenofibrate or candesartan alone(P＜0.05).2,Fenofibrate alone or combined therapy significantly lowered total cholesterol, triglycerides,and LDL cholesterol levels(all P＜0.05) and increased HDL cholesterol levels(P＜0.05)when compared with baseline.These reductions were significantly greater than those observed with candesartan alone(all P＜0.05).However,there were no significant differences between fenofibrate alone and combined therapy for these parameters(P＞0.05).3,Combined therapy significantly decreased the plasma high-sensitivity C-reactive protein level relative to baseline measurement(P＜0.05),and the magnitude of the reduction was significantly greater than with fenofibrate or candesartan therapy alone (P＜0.05,respectively).4,Fenofibrate,combined therapy,or candesartan significantly improved the percent flow-mediated dilator response to hyperemia relative to baseline measurements(all P＜0.05).Importantly,combined therapy significantly improved this response more than fenofibrate or candesartan alone(P＜0.05).5,By linear correlation analysis,we found there were positive correlations between C-reactive protein and blood pressure,total cholesterol,triglycerides,and LDL cholesterol.And there were negative correlation between C-reactive protein and HDL cholesterol.[Conclusions]Fenofibrate combined with candesartan improves the lipoprotein profile and the flow-mediated dilation and reduces blood pressure and high-sensitivity C-reactive protein to a greater extent than monotherapy in hypertriglyceridemic hypertensive patients.