The Role of Vildagliptin in Treating Hypertension Through Modulating Serum VEGF in Diabetic Hypertensive Patients

J Cardiovasc Pharmacol Ther. 2019 May;24(3):254-261. doi: 10.1177/1074248418817345. Epub 2019 Jan 10.

Abstract

Background: Several trials have reported that dipeptidyl peptidase-4 (DPP-4) inhibitors are used to improve endothelial function in addition to treating type 2 diabetes (T2DM). The current study investigated the effects of vildagliptin, DPP-4 inhibitor, compared to metformin on endothelial function and blood pressure through vascular endothelial growth factor (VEGF) modulation in patients with T2DM and hypertension.

Methods: This study was designed as a randomized controlled parallel study. A total of 120 volunteers were recruited and allocated into 4 groups: healthy volunteers, patients recently diagnosed with hypertension and diabetes, patients treated with captopril for hypertension in addition to metformin, and patients treated with captopril in addition to vildagliptin. The percentage change in body weight was calculated in addition to serum VEGF levels, blood pressure, glycated hemoglobin (HbA1c), total lipid profile, and insulin resistance.

Results: At the end of the therapeutic period, the results showed that vildagliptin significantly decreased blood pressure and increased serum VEGF levels, while metformin was more effective at lowering body weight. In comparison with metformin, vildagliptin showed a promising action through its antihypertensive effect via elevating VEGF levels and improving physiological angiogenesis and vasculature.

What is new and conclusion: Vildagliptin showed a promising action through its blood pressure-regulating effect via modulating VEGF levels and improving physiological angiogenesis and vasculature, in addition to improving the lipid profile of patients, while metformin was better in reducing body weight.

Keywords: VEGF; captopril; diabetes; hypertension; metformin; vildagliptin.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use*
  • Biomarkers / blood
  • Blood Pressure / drug effects*
  • Captopril / adverse effects
  • Captopril / therapeutic use*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Dipeptidyl-Peptidase IV Inhibitors / adverse effects
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use*
  • Egypt
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypertension / blood
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Insulin Resistance
  • Lipids / blood
  • Male
  • Metformin / adverse effects
  • Metformin / therapeutic use*
  • Middle Aged
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / blood*
  • Vildagliptin / adverse effects
  • Vildagliptin / therapeutic use*

Substances

  • Antihypertensive Agents
  • Biomarkers
  • Dipeptidyl-Peptidase IV Inhibitors
  • Glycated Hemoglobin A
  • Lipids
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • hemoglobin A1c protein, human
  • Metformin
  • Captopril
  • Vildagliptin