Vildagliptin, glibenclamide exert neutral effect on endothelial function, arterial stiffness
Treatment with either vildagliptin or glibenclamide does not alter both the endothelial function and arterial stiffness in diabetic and hypertensive patients without cardiovascular disease, a study has shown.
The study randomized 50 patients (mean age 59 years; 64 percent female) with type 2 diabetes mellitus (T2DM) and hypertension, but without cardiovascular disease, to receive either vildagliptin (n=25) or glibenclamide (n=25) for 12 weeks in addition to metformin.
All patients underwent 24-hour noninvasive ambulatory blood pressure monitoring. Additionally, researchers evaluated endothelial function using peripheral artery tonometry (Endo-PAT 2000), which facilitated calculation of the reactive hyperaemia index (RHI), and assessed arterial stiffness using the augmentation index corrected for 75 bpm (AIx75), pulse wave velocity (PWV) and central systolic blood pressure (cSBP).
The primary outcome of RHI after 12 weeks of treatment did not change from baseline in both vildagliptin (from 2.35 to 2.24) and glibenclamide (from 2.36 to 2.34) groups. Furthermore, there were no between-group differences observed in AIx75, cSBP and PWV.
RHI did not correlate with glycaemic control, hypertension, T2DM duration, BP and arterial stiffness in either group. On the other hand, PWV was associated with age, central pulse pressure and office blood pressure.
There were no reports of serious adverse events, and the hypoglycaemic events that occurred in two patients who received glibenclamide group were not significant. One patient in the vildagliptin group discontinued treatment prematurely (7 weeks) and had to initiate insulin treatment due to poor glycaemic control.
More studies are needed to confirm differences between vildagliptin and glibenclamide regarding vascular function, researchers said.