Manidipine in hypertensive patients with metabolic syndrome: the MARIMBA study

Abstract

Objectives: To evaluate the effects of manidipine versus amlodipine on blood pressure, albuminuria, insulin sensitivity, adiponectin, TNF-α and C-reactive protein in nondiabetic subjects with metabolic syndrome (ATP-III definition), including impaired fasting glucose (>5.6 mmol/l) and hypertension. Methods: In total, 64 patients were recruited and randomly assigned to manidipine 20 mg versus amlodipine 10 mg (for 12 ± 2 weeks). Results: Blood pressure was reduced to a similar extent (p < 0.001) by both treatments. Albuminuria was significantly reduced by manidipine (-37.3%; p = 0.003), but not by amlodipine. C-reactive protein was reduced similarly (p < 0.01) by both treatments. Plasma adiponectin was increased (32.9%; p = 0.011) and plasma TNF-α was reduced by manidipine (-37.1%; p = 0.019), but neither was significantly changed by amlodipine. The HOMA insulin resistance index was significantly reduced by manidipine (-21.3%; p = 0.007), but not by amlodipine (-8.3%; p = 0.062). Tolerability with manidipine was superior to that with amlodipine (p = 0.04). Conclusion: These data support the added value of manidipine in renal and metabolic protection beyond blood pressure reduction in the treatment of hypertensive patients with metabolic syndrome.

Keywords::

• adiponectin
• amlodipine
• C-reactive protein
• hypertension
• insulin sensitivity
• manidipine
• metabolic syndrome
• microalbuminuria
• TNF-α

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Financial & competing interests disclosure

Francisco J Martinez Martin has received lecture fees from Chiesi Farmaceutici S.p.A, Pfizer, Menarini, Daiichi-Sankyo, Bayer, Lilly, Novo-Nordisk, Sanofi-Aventis, Bristol–Myers–Squibb, Abbot, Novartis and others, and also grant funding from Pfizer, but none directly related to this study. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was utilized in the production of this manuscript. Editorial assistance was provided by Content Ed Net Communications, Madrid, Spain, with funding from Chiesi Farmaceutici S.p.A.