The Comparative Effects of Valsartan and Amlodipine on vWf Levels and N/L Ratio in Patients with Newly Diagnosed Hypertension

Abstract

High levels of circulating Von Willebrand factor (vWf) and increased neutrophil to lymphocyte (N/L) ratio may reflect vascular inflammation in hypertensive patients. In present study, we aimed to investigate the effects of valsartan as an angiotensin II receptor antagonist and amlodipine as a calcium channel blocker on the vWf levels and N/L ratio in patients with essential hypertension. Patients were randomized to one of the following intervention protocols: calcium channel blocker (amlodipine, 5-10 mg/day) as group A (n = 20 mean age = 51.85 ± 11.32 y) and angiotensine II receptor blocker (valsartan, 80-320 mg/day) as group B (n = 26 mean age = 49.12 ± 14.12 y). Endothelial dysfunction and vascular inflammation were evaluated with vWf levels and N/L ratio in hypertensive patients before treatment and after treatment in the 12th week. No statistically significant differences were found among the groups in terms of age, sex, and body mass index (BMI). There was a significant decrease in vWf levels (P < .001) and N/L ratio after treatment (P = .04, P < .001, respectively) in both the groups. Von Willebrand factor levels and N/L ratio are very important markers having a role in vascular inflammation and antihypertensive treatment with amlodipine and valsartan may improve cardiovascular outcomes by decreasing these biomarkers.

A new piece of puzzle: inflammation in the prediction of recurrence after successful electrical cardioversion in patients with nonvalvular atrial fibrillation

“…The N/L ratio is also an inflammatory marker of major adverse cardiac events (9). However, sometimes acute conditions like bacterial or viral infections, chronic inflammatory disease and drug treatments might affect neutrophil and lymphocyte counts and so the ratio of these parameters might be changed (10). Therefore, N/L ratio itself alone without other inflammatory markers may not give information to clinicians about the chronic endothelial inflammatory condition of the patient.…”

“…Multislice computed tomography angiography (MSCTA) is a very useful and an important tool for the noninvasive evaluation, intervention and cure of coronary arterial pathology (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). We present the assessment of three patients with coronary artery disease (a 88-year old man, 62 -year old man and 66 year-old man, using a MSCTA coronary angiography (64-320 slice technology), that was firstly described by Leschka S (5).…”

The Relationship Between Inflammatory Markers and Coronary Collateral Circulation Should be Evaluated Together With Cardiovascular Medications in Stable Coronary Artery Disease

“…Furthermore, it has been shown that antihypertensive medications might also affect NLR levels. 13,14 In a study including 72 newly diagnosed patients with hypertension, Fici et al 13 showed that nebivolol has significantly reduced the NLR levels after 6 months of treatment period. In conclusion, the results of the study by Uysal et al 1 showed that higher levels of NLR were associated with poor CCC in stable CAD, but these results should be interpreted with some limitations, particularly statin and antihypertensive therapy among the study groups.…”

The relation between neutrophil–lymphocyte ratio and acute kidney injury

“…Antihypertensive therapy like nebivolol, valsartan and amlodipine significantly lowered the NLR. 8,12 In this context, medication should be considered, when the NLR is assessed.…”