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

Author(s): Koh KK, Quon MJ, Han SH, Lee Y, Kim SJ, Koh Y, Shin EK

Affiliation(s): Vascular Medicine and Atherosclerosis Unit, Cardiology, Gil Medical Center, Gachon University, Incheon, Republic of Korea. kwangk@gilhospital.com

Publication date & source: 2010-04-01, Int J Cardiol., 140(1):73-81. Epub 2008 Dec 6.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

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. Copyright 2008 Elsevier Ireland Ltd. All rights reserved.

Page last updated: 2010-10-05

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