L’endothélium est une barrière semi-perméable assurant le maintien de l’homéostasie vasculaire. C’est un régulateur clé du tonus vasculaire, des processus de coagulation et de fibrinolyse, et de l’inflammation. Sa dysfonction est à l’origine de nombreuses pathologies parmi lesquelles figurent les complications vasculaires liées au diabète, notamment les maladies cardiovasculaires, première cause de mortalité chez les patients diabétiques. Le stress oxydant associé aux produits avancés de glycation (AGEs), dont la formation est favorisée par l’hyperglycémie, constitue l’élément central de la dysfonction endothéliale. Ce stress correspond à un déséquilibre entre les défenses antioxydantes et les espèces prooxydantes cellulaires en faveur de ces dernières, et peut être d’origine mitochondriale. L’objectif de mon travail de thèse a été de déterminer les effets des AGEs dérivant de l’albumine (la protéine plasmatique la plus abondante) sur le fonctionnement des mitochondries de cellules endothéliales en culture, en parallèle à une analyse des mécanismes moléculaires impliqués dans le stress oxydant intracellulaire, et des fonctions endothéliales. L’étude mitochondriale s’est principalement axée sur la description des états respiratoires et a révélé des phénotypes associés aux AGEs, variant en fonction du modèle cellulaire endothélial et de la confluence. Par ailleurs, deux autres résultats phares issus de mes investigations correspondent à la mise en évidence de : 1) l’altération des propriétés antioxydantes de l’albumine, ainsi que l’acquisition d’un pouvoir pro-oxydant après glycoxydation ; 2) la contribution des mitochondries au stress oxydant, à travers une communication possible avec la NADPH oxydase, une enzyme produisant des anions superoxydes. Ce travail apporte ainsi un nouvel éclairage sur le déséquilibre redox observé chez les cellules endothéliales dans le cadre de la pathologie diabétique, en relation avec l’aspect mitochondrial. / The endothelium ensures the maintenance of vascular homeostasis. It is a fundamental regulator of vascular tone, coagulation, fibrinolysis, and inflammation. Its dysfunction mediates numerous pathologies, including, among others, diabetes vascular complications, particularly cardiovascular diseases, the major cause of mortality in diabetic patients.Oxidative stress related to advanced glycation end products (AGEs), whose formation is enhanced by hyperglycemia, represents the central element of endothelial dysfunction. This stress is defined as “an imbalance between oxidants and anti-oxidants in favor of the oxidants”, and can originate from mitochondria. The objective of my thesis was to determine the effects of AGEs derived from albumin (the most abundant protein in plasma) on mitochondria of cultured endothelial cells, in parallel to an analysis of the molecular mechanisms involved in intracellular oxidative stress, and endothelial functions.Mitochondrial exploration mainly focused on the description of the respiratory states and revealed AGEs-associated phenotypes, depending on endothelial cell model and cell confluence. Furthermore, two other key results from my investigations correspond to the highlighting of: 1) the alteration of albumin antioxidant properties, as well as the acquisition of a pro-oxidant capacity after glycoxidation processes; 2) the involvement of mitochondria in oxidative stress, through a potential communication with NADPH oxidase, an enzyme that produces superoxide anions.This work brings novel insights into the redox imbalance observed in endothelial cells during diabetes, in relation to the mitochondrial aspect.

As doenças cardiovasculares permanecem como a principal causa de morte no mundo, e têm a hipertensão arterial sistêmica (HAS) e o diabetes mellitus tipo 2 (DM2) como uns dos seus principais fatores de risco. Sabidamente, a HAS e o DM2 são doenças frequentemente associadas. A escolha dos fármacos anti-hipertensivos a serem utilizados no tratamento de pacientes hipertensos diabéticos tem como objetivo o controle da pressão arterial, a redução da morbimortalidade das complicações macro e microvasculares. Alterações na função endotelial precedem as alterações morfológicas do vaso e contribuem para o desenvolvimento das complicações macrovasculares. O objetivo deste estudo foi avaliar a associação de alterações vasculares funcionais com o uso de losartana ou anlodipino em pacientes hipertensos e diabéticos tipo 2. Foi realizado um estudo transversal com coleta de dados prospectiva. Os pacientes incluídos foram randomizados e divididos em dois grupos, sendo avaliados na sexta semana da utilização de losartana 100 mg/dia ou anlodipino 5 mg/dia, com aferição da PA, realização de monitorização ambulatorial da pressão arterial e testes para avaliação de parâmetros vasculares como tonometria de aplanação, velocidade de onda de pulso (VOP) e dilatação mediada por fluxo (DMF) da artéria braquial. Foram incluídos 42 pacientes, 21 em cada grupo. A distribuição da amostra demonstrou uma predominância do sexo feminino (71%) nos dois grupos e uma semelhança na idade média dos pacientes (54,06,9 anos, no grupo losartana e 54,94,5 anos, no grupo anlodipino). A média dos valores de pressão arterial na sexta semana foram 15319/909 mmHg no grupo losartana e 14514/848 mmHg no grupo anlodipino, não havendo diferença estatística entre os grupos. O augmentation index (AIx; 309% vs. 368%, p=0,025), assim como a augmentation pressure (166 mmHg vs. 208 mmHg, p=0,045) foram menores no grupo anlodipino do que no grupo losartana. Os valores obtidos para VOP e DMF foram semelhantes nos dois grupos. Em pacientes hipertensos e diabéticos tipo 2, o tratamento com anlodipino em dose média comparado com losartana em dose máxima associou-se a menores níveis de pressão arterial casual. Menores valores de AIx foram observados no grupo anlodipino, com um padrão de reflexão da onda de pulso mais favorável neste grupo. Os valores da VOP e DMF encontrados foram semelhantes nos dois grupos podendo sugerir influências da losartana sobre os parâmetros vasculares independentes do efeito pressórico. / Cardiovascular diseases are still the leading cause of death worldwide, and hypertension and diabetes are among its major risk factors. It is well known that hypertension and type 2 diabetes are often associated diseases. The choice of antihypertensive drugs to be used in the treatment of hypertensive patients with diabetes aims to control blood pressure, reducing morbidity and mortality from macrovascular and microvascular complications. Changes in endothelial function precede morphological vascular changes and contribute to the development of macrovascular complications. The aim of this study was to evaluate the association of vascular function with the use of losartan or amlodipine in hypertensive type 2 diabetics. A cross-sectional study was conducted with patients randomly divided into two groups, being evaluated in the sixth week of using losartan 100 mg / day or amlodipine 5 mg / day, with BP measurement, performance of ambulatory blood pressure monitoring and tests to evaluate vascular parameters such as applanation tonometry, pulse wave velocity (PWV) and flow-mediated dilatation (FMD) of the brachial artery. We included 42 patients, 21 in each group. The distribution of the sample showed a female predominance (71%) in both groups and a similarity in the average age (54.0 6.9 years in the losartan group and 54.9 4.5 years in group amlodipine). At 6 weeks of antihypertensive treatment, the mean blood pressure values were 153 19/90 9 mmHg in the losartan group and 145 14/84 8 mmHg in the amlodipine group, with no statistical difference between the groups. The augmentation index (AIx; 30 9 vs. 8 36%, p=0.025) as well as augmentation pressure (16 6 vs. 8 20 mmHg, p=0.045) in the amlodipine group was lower than in group losartan. The values obtained for PWV and FMD were similar in both groups. In hypertensive patients with type 2 diabetes, treatment with amlodipine on average dose compared to maximum dose of losartan was associated with lower levels of casual blood pressure. Lower values of AIx were observed in the amlodipine group, with a more favorable standard pulse wave reflection in this group. The similar values of PWV and FMD in the two groups may suggest influences of losartan on vascular parameters independent of the blood pressure effect.

Obesity is associated with chronic inflammation and increased risk of developing cardiovascular disease (CVD). Obesity is also associated with nitric oxide (NO)-mediated vascular endothelial dysfunction (VED), an independent predictor of increased CVD risk in humans. Pro-inflammatory cytokines secreted by the adipose tissue, such as TNF-Α, may contribute to VED through promotion of insulin resistance or directly through a reduction in endothelial NO synthase (eNOS) expression and/or phosphorylation. Sodium salicylate (Na-Sal) is a non-acetylated aspirin that inhibits the pro-inflammatory transcription factor nuclear factor-ΚB (NF-ΚB) and activates the cellular metabolism regulator AMP-activated protein kinase (AMPK). AMPK is a known activator of eNOS. We tested the hypothesis that Na-Sal increases eNOS expression/phosphorylation in TNFΑ-stimulated endothelial cells through an AMPK-dependent mechanism. Human aortic endothelial cells (HAECs) incubated in vitro with TNF-Α (10 ng/ml, 2 hrs) demonstrated decreased (vs. control) expression (via Western blotting) of eNOSser1177 phosphorylation (n=8; PThr172 phosphorylation (n=8, Pser1177 phosphorylation (vs. control, n=7; P=0.14) and AMPKThr172 phosphorylation (vs. control, n=9; P=0.42). The AMPK activator AICAR prevented eNOSser1177 phosphorylation down-regulation by TNF-Α in a manner similar to Na-Sal (n=2, P=0.839). Co-treatment with the AMPK inhibitor compound C (10 μM, 30 min) abolished the ability of Na-Sal to prevent down-regulation of eNOSser1177 phosphorylation by TNF-Α (vs. control, n=3; Pser1177 in endothelial cells in part through AMPK.

Polyphenols are naturally-occurring phytochemicals, which form an integral part of the human diet. Results from epidemiological studies have associated polyphenol intake with reduced risk of cardiovascular diseases. Previous human intervention studies suggested that dietary polyphenols exert their cardioprotective effects through their antioxidant and anti-inflammatory effects. While most in vitro experiments have not accounted for the bioavailability and metabolism of these polyphenols, our work has provided direct evidence, using quercetin, that metabolic transformation, together with bioavailability, exert profound effects on bioactivity. We examined the effect of quercetin and its major metabolites on the production of pro-inflammatory eicosanoids by human leukocytes. Studies comparing free radical scavenging, antioxidant activity and eicosanoid production demonstrate that there are different structural requirements for antioxidant and anti-inflammatory activity. We also investigated the effect of metabolic transformation on flavonoid bioactivity by comparing the activity of quercetin and its major metabolites to inhibit inflammatory eicosanoid production from human leukocytes. Quercetin was a potent inhibitor of leukotriene B4 formation in leukocytes (IC50 ~ 2µM), and its activity was dependent on specific structural features, particularly the 2,3 double bond of the C ring. Functionalisation of the 3'-OH group with either methyl or sulfate reduced inhibitory activity up to 50% while a glucuronide substituent at the 3-OH effectively removed the leukotriene B4 inhibitory activity. The major quercetin metabolite quercetin-3'-O-sulfate retained considerable lipoxygenase inhibitory activity (IC50 ~ 7 µM) while quercetin-3-O-glucuronide maintained antioxidant activity but had no lipoxygenase inhibitory activity at physiologically relevant concentrations. We conclude that structural modification of quercetin due to metabolic transformation had a profound effect on bioactivity, and that the structural features required for antioxidant activity of 8 quercetin and related flavonoids were unrelated to those required for inhibition of inflammatory eicosanoids.

Thesis ((Ph.D. (Physiology))--North-West University, Potchefstroom Campus, 2010.

Thesis ((Ph.D. (Physiology))--North-West University, Potchefstroom Campus, 2010.

Typ-2-Diabetiker haben ein hohes kardiovaskuläres Risiko. Es wurden 23 Typ-2-Diabetiker in eine Interventions- und eine Kontrollgruppe randomisiert. Die Interventionsgruppe nahm an einem multifaktoriellen Sekundärpräventionsprogramm mit Fokus auf intensivem körperlichen Training teil. Die Kontrollgruppe wurde leitlinienkonform durch die Hausärzte therapiert. Nach einem vierwöchigen stationären Training trainierte die Interventionsgruppe über fünf Monate zu Hause. Beide Gruppen wurden bei Studienbeginn, nach vier Wochen und nach sechs Monaten umfassend untersucht (Ergometrie, Labordiagnostik verschiedener Stoffwechselparameter, Messung der Endothelfunktion, Quantifizierung der koronaren Plaquelast). Nach vier Wochen sowie nach sechs Monaten Training zeigte sich in der Interventionsgruppe eine Verbesserung von Gewicht, BMI, maximaler Trainingsintensität und Trainingsdauer. Weiterhin zeigte sich nach vier Wochen Training eine signifikante Verbesserung der Stoffwechselparameter, die nach sechs Monaten nicht mehr nachweisbar war. Die Endothelfunktion verbesserte sich erst nach sechs Monaten Training signifikant. Die koronare Plaquelast veränderte sich nicht. Die Kontrollgruppe zeigte zu keinem Zeitpunkt Veränderungen. Ein intensives multifaktorielles Interventionsprogramm kann die endotheliale Dysfunktion der Koronararterien von Typ-2-Diabetikern korrigieren, ohne eine quantitative Regression der Atherosklerose zu erreichen. Ein stationäres Training verbessert die Stoffwechselsituation gegenüber einem Heimtraining, vermutlich durch verbesserte Compliance und bessere diätetische Kontrolle.

Contexto: A suplementação de ácido fólico (AF) melhora a função endotelial de indivíduos infectados pelo HIV em uso contínuo de terapia antirretroviral (TARV). A literatura não demonstra com clareza esse benefício em indivíduos coinfectados HIV-HCV. Introdução: Indivíduos infectados pelo HIV ou em coinfecção pelo HIV-HCV apresentam um conjunto de fatores de risco que podem levar a disfunção endotelial. Estudos demonstram que a administração de AF possui efeitos benéficos sobre a função endotelial de diferentes populações com risco cardiovascular, inclusive em HIV monoinfectados. Objetivo: Determinar o efeito da suplementação de AF por quatro semanas sobre a dilatação mediada (FMD) pelo fluxo da artéria braquial em indivíduos infectados pelo HIV ou HIV-HCV em uso contínuo de TARV. Delineamento: Ensaio clínico randomizado (ECR), controlado por placebo. Local: Ambulatório de doenças infecciosas do Hospital Universitário de Santa Maria. População: Foram avaliados 69 indivíduos com idade entre 18-50 anos, de ambos os sexos, infectados pelo HIV com ou sem coinfecção pelo HCV, em TARV e com carga viral indetectável há mais de seis meses. Excluíram-se participantes com diabetes mellitus, infarto agudo do miocárdio, revascularização miocárdica, ou acidente vascular encefálico prévios, com creatinina >1,5 mg/dL, diagnóstico clínico, ecográfico, endoscópico ou laboratorial de cirrose hepática, em uso de estatinas, fibratos, terapia de reposição hormonal, sulfonamidas, suplementos vitamínicos, ou AF nos últimos 30 dias. Adicionalmente foram excluídas mulheres grávidas, e participantes de outro ECR. Intervenção: Indivíduos alocados para o grupo intervenção receberam AF, 5 mg, via oral, em dose única diária, pela manhã, durante quatro semanas. Os participantes alocados para grupo placebo receberam orientação para seguir a mesma posologia, sendo os comprimidos indistinguíveis em cor, aroma, sabor, forma e tamanho. Desfechos: Utilizaram-se as variações nos níveis de homocisteína, vitamina B12 e na FMD, aferida por Doppler, na artéria braquial, obtidos na randomização e ao final do seguimento. Resultados: Realizou-se o rastreamento de 239 participantes, sendo 72 elegíveis, 69 randomizados e 68 acompanhados, entre outubro de 2012 e julho de 2013. Em indivíduos infectados pelo HIV houve aumento significativo nos níveis de AF (12,8 ng/ml) no grupo intervenção em comparação ao placebo (P<0,001), acompanhada de variação negativa de homocisteína (-1,9 umol/l) no grupo intervenção e aumento mínimo no grupo placebo (P<0,001). Não houve variação significativa na FMD (P=0,9). Entre indivíduos coinfectados por HIV-HCV, a variação nos níveis de AF foi decorrente da elevação no grupo intervenção (12,6 ng/ml) e redução no grupo placebo (-0,7 ng/ml) (P<0,001). Os níveis de homocisteína aumentaram no grupo placebo (4,6 umol/l) e diminuíram no grupo intervenção (-1,0 umol/l) (P<0,0003). Em relação ao FMD, houve tendência à redução percentual no grupo intervenção e aumento no grupo placebo (P=0,007). As variações de vitamina B12 não foram significativas, independente do status de infecção para HCV. Conclusão: Esse estudo demonstrou que a suplementação de AF por um curto período de tempo, esteve associada com redução de homocisteína sérica, mas não modificou a FMD da artéria braquial, aferida por Doppler, em indivíduos adultos infectados pelo HIV ou HIV-HCV em uso de TARV. / Context: The supplementation of folic acid (FA) improves endothelial function in HIV-infected individuals in continuous use of highly active antiretroviral therapy (HAART). The literature does not clearly show this benefit in coinfected HIV-HCV. Introduction: Individuals infected with HIV or HIV-HCV coinfected presents a set of risk factors that can lead to endothelial dysfunction. Studies show that FA management has beneficial effects on endothelial function in different populations with cardiovascular risk, including HIV monoinfected. Objective: To determine the effect of FA supplementation for four weeks on the mediated dilation (FMD) by brachial artery flow in patients infected with HIV or HIV-HCV continuous HAART. Design: Randomized clinical trial (RCT), placebo-controlled study. Location: Division of Infectious Diseases, University Hospital of Santa Maria. Population: A total of 69 subjects aged 18-50 years, of both sex, HIV or HIV-HCV infected, on HAART, with undetectable viral load for more than six months. Patients presenting with diabetes mellitus, acute myocardial infarction, coronary revascularization, or stroke prior, with creatinine >1,5 mg/dL, clinical diagnosis, ultrasound, endoscopic or laboratory evidence of liver cirrhosis, on statins, fibrates, hormone replacement therapy, sulfonamides, vitamin supplements, or FA in the last 30 days. In addition pregnant women were excluded, and participants in a RCT. Intervention: Subjects allocated to the intervention group received FA, 5 mg orally once daily in the morning for four weeks. Participants allocated to placebo group were instructed to follow the same dosage, being indistinguishable tablets in color, aroma, taste, shape and size. Outcomes: changes were used in the levels of homocysteine, vitamin B12 and FMD, measured by Doppler, in the brachial artery obtained at randomization and at the end of follow-up. Results: We carried out the screening of 239 participants, 72 eligible, 69 randomized and 68 accompanied, between October 2012 and July 2013. In HIV-infected patients there was a significant increase in the levels of FA (12.8 ng/ml) in the intervention group compared to placebo (P <0.001), accompanied by negative variation of homocysteine (1.9 umol/L) in the group intervention and minimal increase in the placebo group (P <0.001). There was no significant change in FMD (P = 0.9). Between individuals coinfected with HIV-HCV, the variation in FA levels was due to the increase in the intervention group (12.6 ng/ml) and reduction in the placebo group (-0.7 ng / ml) (P <0.001). Homocysteine levels increased in the placebo group (4.6 umol/L) and decreased in the intervention group (-1.0 umol/L) (P <0.0003). Regarding the FMD, there was a tendency to percentage reduction in the intervention group and increased in the placebo group (P = 0.007). Variations of B12 were not significant, independent of HCV infection status. Conclusion: This study showed that AF supplementation for a short term, was associated with reduced serum homocysteine, but did not change the FMD of the brachial artery, measured by Doppler in adults infected with HIV or HIV-HCV in HAART.

Obesity is a world phenomenon caracterized as a cronic metabolic disorder, where the excess of adipose tissue is responsable for oxidative stress, inflammation and endothelial dysfunction states. Due the higher number of obese people and the mortality due pathologies associated to obesity, studies that contibute to the prevention and monitoring are important. So, the study of oxidative stress, inflammatory and endothelial dysfunction biomarkers that dectect earlier damages caused by obesity can contibute to its better physiopathology understanding, such as its diagnosis and monitoring. In this work the study population was constituted by obese and overweight subjects and healthy control. The main objectives from this work were, in the study population: evaluate the behavior from some oxidative stress markers malondialdehyde (MDA), ischemia-modified albumin (IMA), advanced oxidation protein products (AOPP) and plasma thiol ( SH); evaluate the proinflammatory citokine interleukin-6 (IL-6) levels; determine the laboratory marker levels related to the endothelial dysfunction nitric oxide (NO) and albuminury and investigate the behavior from lipidic and glicemic biomarkers, such as the prevalente of diabetes mellitus and hypertension. The obese subjects compared with the others studied subjects presented: higher levels of MDA, IMA and AOPP, showing a lipidic and proteic oxidation (mainly the albumin protein); increasing of IL-6 levels that caracterize a significative proinflammatory state; lower levels of NOx with consequent NO bioavailability reduction and increasing of albuminury, reflecting a probable endothelial dysfunction; discrete HDL cholesterol levels reduction and increasing of glucose, such as higher prevalence of diabetes and hypertension. Therefore, considering the obtained results, we observed that the obese subjects presented changes related to oxidative, inflammatory and vascular processes, showing that the evaluation of biomarkers associated with these processes has a great importance to better understanding of obesity physiopathology that avoid related pathologies and their consequent mortality. / A obesidade é um fenômeno mundial caracterizado por uma desordem metabólica crônica, em que o excesso de tecido adiposo é responsável por estados de estresse oxidativo, inflamação e disfunção endotelial. Devido ao crescente número de pessoas obesas e à mortalidade decorrente de patologias associadas à obesidade, faz-se necessário a realização de estudos que contribuam para a prevenção e monitoramento desta. Para tanto, o estudo de biomarcadores de estados oxidativos, inflamatórios e de dano endotelial que detectem precocemente os danos causados pela obesidade podem contribuir para o melhor entendimento da fisiopatologia da doença, bem como seu diagnóstico e monitoramento. Neste trabalho a população estudada constituiu-se de indivíduos obesos, com sobrepeso e controles saudáveis. Os objetivos principais deste trabalho foram, na população em estudo: avaliar o comportamento de alguns marcadores de estresse oxidativo malondialdeído (MDA), albumina modificada pela isquemia (IMA), produtos protéicos de oxidação avançada (AOPP) e grupamento tiol plasmático (-SH); avaliar os níveis da citocina pró-inflamatória interleucina-6 (IL-6); determinar os níveis de marcadores laboratoriais relacionados à disfunção endotelial óxido nítrico (NO) e albuminúria e investigar o comportamento de biomarcadores lipídicos e glicêmicos, bem como a prevalência de diabetes mellitus e hipertensão. Os indivíduos obesos, em comparação com os demais indivíduos estudados apresentaram: níveis mais elevados de MDA, IMA e AOPP, denotanto uma oxidação lipídica e protéica (principalmente da proteína albumina); elevação dos níveis de IL-6, caracterizando um estado pró-inflamatório significativo; baixos níveis de NOx com conseqüente redução da biodisponibilidade de NO e elevação da albuminúria, refletindo provável disfunção endotelial; redução discreta nos níveis de HDL colesterol, e elevação dos níveis de glicose bem como maior prevalência de diabetes e hipertensão. Sendo assim, considerando-se os resultados obtidos, observou-se que os indivíduos obesos apresentaram alterações relacionadas a processos oxidativos, inflamatórios e vasculares, sendo a avaliação de biomarcadores associados a tais processos de grande importância para melhor entender a fisiopatologia da doença, evitando patologias relacionadas e a mortalidade decorrente delas.

As doenças cardiovasculares permanecem como a principal causa de morte no mundo, e têm a hipertensão arterial sistêmica (HAS) e o diabetes mellitus tipo 2 (DM2) como uns dos seus principais fatores de risco. Sabidamente, a HAS e o DM2 são doenças frequentemente associadas. A escolha dos fármacos anti-hipertensivos a serem utilizados no tratamento de pacientes hipertensos diabéticos tem como objetivo o controle da pressão arterial, a redução da morbimortalidade das complicações macro e microvasculares. Alterações na função endotelial precedem as alterações morfológicas do vaso e contribuem para o desenvolvimento das complicações macrovasculares. O objetivo deste estudo foi avaliar a associação de alterações vasculares funcionais com o uso de losartana ou anlodipino em pacientes hipertensos e diabéticos tipo 2. Foi realizado um estudo transversal com coleta de dados prospectiva. Os pacientes incluídos foram randomizados e divididos em dois grupos, sendo avaliados na sexta semana da utilização de losartana 100 mg/dia ou anlodipino 5 mg/dia, com aferição da PA, realização de monitorização ambulatorial da pressão arterial e testes para avaliação de parâmetros vasculares como tonometria de aplanação, velocidade de onda de pulso (VOP) e dilatação mediada por fluxo (DMF) da artéria braquial. Foram incluídos 42 pacientes, 21 em cada grupo. A distribuição da amostra demonstrou uma predominância do sexo feminino (71%) nos dois grupos e uma semelhança na idade média dos pacientes (54,06,9 anos, no grupo losartana e 54,94,5 anos, no grupo anlodipino). A média dos valores de pressão arterial na sexta semana foram 15319/909 mmHg no grupo losartana e 14514/848 mmHg no grupo anlodipino, não havendo diferença estatística entre os grupos. O augmentation index (AIx; 309% vs. 368%, p=0,025), assim como a augmentation pressure (166 mmHg vs. 208 mmHg, p=0,045) foram menores no grupo anlodipino do que no grupo losartana. Os valores obtidos para VOP e DMF foram semelhantes nos dois grupos. Em pacientes hipertensos e diabéticos tipo 2, o tratamento com anlodipino em dose média comparado com losartana em dose máxima associou-se a menores níveis de pressão arterial casual. Menores valores de AIx foram observados no grupo anlodipino, com um padrão de reflexão da onda de pulso mais favorável neste grupo. Os valores da VOP e DMF encontrados foram semelhantes nos dois grupos podendo sugerir influências da losartana sobre os parâmetros vasculares independentes do efeito pressórico. / Cardiovascular diseases are still the leading cause of death worldwide, and hypertension and diabetes are among its major risk factors. It is well known that hypertension and type 2 diabetes are often associated diseases. The choice of antihypertensive drugs to be used in the treatment of hypertensive patients with diabetes aims to control blood pressure, reducing morbidity and mortality from macrovascular and microvascular complications. Changes in endothelial function precede morphological vascular changes and contribute to the development of macrovascular complications. The aim of this study was to evaluate the association of vascular function with the use of losartan or amlodipine in hypertensive type 2 diabetics. A cross-sectional study was conducted with patients randomly divided into two groups, being evaluated in the sixth week of using losartan 100 mg / day or amlodipine 5 mg / day, with BP measurement, performance of ambulatory blood pressure monitoring and tests to evaluate vascular parameters such as applanation tonometry, pulse wave velocity (PWV) and flow-mediated dilatation (FMD) of the brachial artery. We included 42 patients, 21 in each group. The distribution of the sample showed a female predominance (71%) in both groups and a similarity in the average age (54.0 6.9 years in the losartan group and 54.9 4.5 years in group amlodipine). At 6 weeks of antihypertensive treatment, the mean blood pressure values were 153 19/90 9 mmHg in the losartan group and 145 14/84 8 mmHg in the amlodipine group, with no statistical difference between the groups. The augmentation index (AIx; 30 9 vs. 8 36%, p=0.025) as well as augmentation pressure (16 6 vs. 8 20 mmHg, p=0.045) in the amlodipine group was lower than in group losartan. The values obtained for PWV and FMD were similar in both groups. In hypertensive patients with type 2 diabetes, treatment with amlodipine on average dose compared to maximum dose of losartan was associated with lower levels of casual blood pressure. Lower values of AIx were observed in the amlodipine group, with a more favorable standard pulse wave reflection in this group. The similar values of PWV and FMD in the two groups may suggest influences of losartan on vascular parameters independent of the blood pressure effect.