Nebivolol Attenuates Neutrophil Lymphocyte Ratio: A Marker of Subclinical Inflammation in Hypertensive Patients.

BACKGROUND: High value of neutrophil lymphocyte ratio (NLR) is a strong independent predictor and biomarker of ongoing vascular inflammation in various cardiovascular disorders. OBJECTIVE: The main focus of the study is to investigate the effect of nebivolol on NLR in mild to moderate hypertensive patients in comparison with metoprolol. In addition, BMI, blood pressure, TLC count, blood sugar, and lipid profile were also assayed before and after treatment. MATERIALS AND METHODS: In this 12-week prospective double-blinded randomized study, 120 patients with mild to moderate hypertension were randomly divided into two groups to prescribed daily dose of tab nebivolol 5-10 mg and metoprolol 50-100 mg, respectively, for 12 weeks. The data were analyzed using SPSS 16 software. RESULTS: A total of 100 patients completed the study. Both drugs lowered blood pressure significantly, nebivolol 20.5/10.5 and metoprolol 22.5/11.2 (p < 0.001) from baseline. Regarding inflammation, nebivolol reduced total leukocyte count (p = 0.005) and neutrophil count (p = 0.003) and increased lymphocyte count (p = 0.004) as compared to metoprolol. Similarly, nebivolol but not metoprolol significantly reduced NLR ratio (p = 0.07). Nebivolol improved lipid profile and blood sugar compared to metoprolol, but values were nonsignificant. CONCLUSION: Nebivolol has a strong impact on reducing NLR, a marker of subclinical inflammation in hypertensive patients. Moreover NLR can be used as a disease and drug monitoring tool in these patients.

Effect Of Sitagliptin On Glycemic Control, Body Weight, Blood Pressure And Serum Lipid Profile In Type 2 Diabetic Hyperlipidemic Patients.

BACKROUND: Dyslipidaemia is a global health issue in developed as well as in developing countries. People with type 2 Diabetes mellitus are more susceptible to develop dyslipidaemia and its related complications. The objective of the study was to assess the effect of sitagliptin a (DPP-4 inhibitor) oral antidiabetic drug on blood sugar, body weight, blood pressure and dyslipidaemia in type 2 diabetic patients. METHODS: This 12 weeks open label observational study was conducted at outdoor of diabetic clinic of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan in which newly diagnosed type 2 diabetic patients (n=78) with poor glycaemic control(HbA1c >7.2%) were selected. The patient received sitagliptin 50 mg twice daily for 12 weeks. RESULTS: After 12 weeks treatment with sitagliptin, there was a significant reduction in the value of HbA1c from 8.184%±0.467 at baseline to 7.0200%±0.459 at 12 weeks (p<0.05). Body weight also decreased significantly from 80.21kg±7.156 at baseline to 71.74 kg±6.567 at 12 weeks (p<0.05).Systolic blood pressure decreased (SBP) decreased significantly from 138.17±6.050 mmHg at baseline to 131.22±6.311 mmHg at 12 weeks (p<0.05). Significant changes were also seen in diastolic blood pressure which decreased from 83.14±6.714 mmHg at baseline to 75.28±6.481 mmHg at 12 weeks (p<0.05). Significant reduction in the serum level of total Cholesterol (TC), triglycerides (TG) and Low density lipoprotein cholesterol (LDL-C) were detected (TC: 222.09±13.538 to 209.41±13.475 mg/dl, p<0.05; TG: 170.99±6.940 to 143.45±8.279 mg/dl, p<0.05; LDL-C 120.00±5.804 to 109.06±6.278 mg/dl, p<0.05). High density lipoprotein cholesterol (HDL-C) increased significantly from 42.99±4.836 mg/dl at baseline to 49.97±3.490 mg/dl at 12 weeks. CONCLUSIONS: Sitagliptin not only improves blood glucose control but also body weight, blood pressure and lipid profile in type 2 diabetic hyperlipidaemia patients.

Beneficial effects of sitagliptin and metformin in non-diabetic hypertensive and dyslipidemic patients.

Obesity, dyslipidemia and hypertension are major risk factors for cardiovascular disease and its associated complications. To evaluate the beneficial effects of sitagliptin and metformin in non-diabetic dyslipidemic and hypertensive patients. A prospective randomized clinical trial was conducted on 70 newly diagnosed dyslipidemic patients with BMI > 25 and blood pressure > 130/80 at outpatient clinic of medical unit-1 of Sheikh Medical College/Hospital, Rahim Yar Khan. They were divided in to three groups each containing 35 patients; First group served as a healthy control while second and third study groups were given tablet sitagliptin 50mg and tab metformin 850mg respectively twice a day for twelve weeks. After three months treatment with sitagliptin and metformin there was significant reduction in body weight (Sitagliptin 6.5% vs Metformin 7.65%) and BMI (Sitagliptin 2.2% vs Metformin 2.8%) with p <0.05. Metformin caused a significant reduction in blood pressure with p < 0.05 (i.e. SBP 9.9% & DBP 6.4%) while sitagliptin caused a highly significant p <0.01 reduction in blood pressure (i.e. SBP 15.8% & DBP 12.2%). There was significant improvement in lipid profile with sitagliptin p<0.05. The percent reduction in value of TC, TG and LDL-C was 20.2%, 13.8% and 23.7% while HDL-C value was increased 11.2% respectively. There was highly significant improvement in lipid profile with metformin p<0.01. The percent reduction in value of TC, TG and LDL-C was 27.8%, 28.2% and 40.4% while HDL-C value was increased 16.8% respectively. Both drugs improve cardiometabolic risk factors independently in non-diabetic patients.