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Distinct vascular and metabolic effects of different classes of anti-hypertensive drugs.

Abstract：

BACKGROUND:ASCOT-BPLA study demonstrates that in hypertensive subjects, atenolol+bendroflumethiazide therapy is associated with higher incidence of adverse cardiovascular outcomes and developing diabetes than an amlodipine+perindopril regimen. This is not explained by changes in blood pressure alone. We hypothesized that distinct vascular and metabolic effects of anti-hypertensive drugs may explain these differential effects. METHODS:Either placebo or one class of anti-hypertensive drug (atenolol 100 mg, amlodipine 10 mg, hydrochlorothiazide 50 mg, ramipril 10 mg, or candesartan 16 mg) was given daily during 8 weeks to 31 patients in each of 6 arms of a randomized, single-blind, placebo-controlled, parallel study. RESULTS:Atenolol, amlodipine, and candesartan therapies significantly reduced systolic blood pressure when compared with ramipril (P<0.05 by ANOVA). Atenolol and thiazide therapies increased triglycerides levels greater than ramipril or candesartan (P=0.005 by ANOVA). Amlodipine significantly increased HDL cholesterol levels greater than atenolol (P=0.011 by ANOVA). Ramipril and candesartan therapies improved FMD and increased adiponectin levels and insulin sensitivity to a greater extent than atenolol or thiazide therapies (P<0.001 and P<0.015 by ANOVA). Amlodipine therapy increased adiponectin levels greater than atenolol therapy (P<0.05 by ANOVA). Ramipril, candesartan, and amlodipine therapies significantly decreased leptin levels to a greater extent when compared with atenolol or thiazide therapies (P<0.001 by ANOVA). Amlodipine therapies significantly decreased resistin levels greater than ramipril or candesartan therapies (P=0.001 by ANOVA). CONCLUSIONS:We observed differential effects of anti-hypertensive drugs on endothelial dysfunction and plasma adipocytokines.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Koh KK,Quon MJ,Han SH,Lee Y,Kim SJ,Koh Y,Shin EK

doi

10.1016/j.ijcard.2008.11.017

subject

Has Abstract

pub_date

2010-04-01 00:00:00

pages

73-81

issue

1

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(08)01153-4

journal_volume

140

pub_type

杂志文章,随机对照试验

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