Biochemical, structural and clinical analysis of statins’ pleiotropic effects

Based on the analysis of clinical and experimental studies, an attempt to explain pleiotropic effects of statins and their numerous action mechanisms has been performed. The pleiotropic effect concept includes: (a) medication effects on numerous targets, triggering various biochemical processes in the organism; b) the divergence of bio­chemical and pathophysiological processes triggered by one target. The pathochemical mechanisms of statins’ effects as HMG-CoA reductase inhibitors are explained. The authors also justify the independence of therapeutic and adverse effects of statins from their lipid and cholesterol-related mechanisms of action

SIGNIFICANCE OF BASELINE ACE ACTIVITY IN PATIENTS WITH METABOLIC SYNDROME WHEN ADMINISTRATION OF ACE INHIBITORS AND IMIDAZOLINE AGONISTS IS CONSIDERED

Significance of baseline ACE activity in patients with metabolic syndrome when administration of ACE inhibitors and imidazoline agonists is considered

Perindopril and hydrochlorthiazide effects on endothelium-dependent vasodilatation and angiotensin-converting enzyme activity in patients with mild to moderate arterial hypertension

Aim. During 12-week perindopril (PR) and hypothiazide (HT) therapy, to study its antihypertensive efficacy, as well as its influence on endothelial function (EF) and angiotensin-converting enzyme (ACE) serum activity, in patents with essential arterial hypertension (EAH). Material and methods. The study included 20 males (mean age 48.8±8.4 years) with mild to moderate AH. Antihypertensive efficacy was assessed during office BP measurement (Korotkoff method) and 24-hour blood pressure monitoring (BPM). EF was assessed by endothelium-dependent vasodilatation (EDVD) during reactive hyperemia test (RHT). Results. According to office BP measurements, target BP level (<140/90 mm Hg) was achieved in 75% patients on PR monotherapy, and 65% on HT monotherapy. According to 24-hour BPM, PR influenced BP levels more beneficially than HT. During PR and HT monotherapy, antihypertensive effect was more pronounced in patients with moderate AH (p=0.06). PR monotherapy caused some EDVD increase in patients with moderate AH (by 10%; NS), but did not affect EDVD in individuals with mild AH. HT treatment substantially increased EDVD in patients with mild AH (by 24%, from 7.13 to 9.18) and even more in participants with moderate AH (by 54%, from 6.52 to 10.02). PR therapy significantly reduced ACE activity, increased at baseline, to 28.1 nmol/min•ml (-43%, p<0.01). In patients with initially low ACE activity, it remained at the same level (reduction to 21.16 nmol/min•ml, NS). HT treatment did not affect this parameter in participants with low or high initial ACE activity. Conclusion. PR and HT antihypertensive effects were associated with EDVD correction. PR and HT antihypertensive efficacy depended on baseline ACE activity. Both drugs could be used for BP correction in individuals with low ACE activity; for patients with initially high ACE activity, PR is more effective