The effect of danshen ligustrazine injection as adjuvant therapy on serum levels of salusins, catestatin, MMP-2, MMP-9, and TIMP-1 in patients with primary hypertension.

Abstract

Background: Primary hypertension is a leading public health issue, contributing significantly to cardiovascular diseases, cerebrovascular events, and renal complications. Despite advancements in pharmacotherapy, optimal blood pressure control remains challenging. Danshen Ligustrazine Injection, derived from Salvia miltiorrhiza and Ligusticum chuanxiong, is purported to have cardiovascular benefits. This study aimed to fill the gap in understanding how Danshen Ligustrazine Injection affects key biomarkers associated with hypertension, which have been underexplored in current research. We investigated its effect as an adjunctive therapy on serum levels of salusin-α, catestatin, matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinases-1 (TIMP-1) in patients with primary hypertension.

Methods: A retrospective cohort study was conducted with 300 patients with primary hypertension admitted from June 2021 and June 2023. Patients were divided into two groups: a conventional group (n = 163) receiving levamlodipine besylate and a combined group (n = 137) receiving levamlodipine besylate plus Danshen Ligustrazine Injection for 5 weeks. Serum levels of salusin-α, catestatin, MMP-2, MMP-9, and TIMP-1 were measured before and after treatment using enzyme-linked immunosorbent assay (ELISA). Clinical efficacy and adverse reactions were also evaluated.

Results: Baseline characteristics, blood routine profiles, and lipid levels were comparable between the groups (P > 0.05). Post-treatment, the conventional group showed a reduction in salusin-α levels to 227.0 ± 22.8 pg/mL (P = 0.006 compared to pre-treatment), while the combined group exhibited a more pronounced decrease to 214.5 ± 26.4 pg/mL (P < 0.001 compared to pre-treatment, P < 0.001 between groups). Catestatin levels increased significantly more in the combined group (186.2 ± 22.3 pg/mL) than in the conventional group (177.5 ± 23.4 pg/mL, P = 0.001). Both MMP-2 and MMP-9 levels were significantly lower in the combined group post-treatment (MMP-2: 207.9 ± 21.6 ng/mL; MMP-9: 125.8 ± 21.3 ng/mL, P < 0.01) compared to the conventional group. TIMP-1 levels were higher in the combined group (126.9 ± 14.8 ng/mL) versus the conventional group (121.8 ± 13.4 ng/mL, P = 0.002). The total effective rate was higher in the combined group (90.5%) than the conventional group (72.4%, P < 0.001), with no significant difference in adverse reactions.

Conclusion: Danshen Ligustrazine Injection as adjuvant therapy favorably modulates serum levels of salusin-α, catestatin, MMP-2, MMP-9, and TIMP-1 in patients with primary hypertension, which appears to correlate with improved clinical outcomes without increasing adverse reactions.

Clinical trial number: Not applicable.