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.

• Authors: Kwang Kon Koh, Michael J Quon, Seung Hwan Han, Yonghee Lee, Soo Jin Kim, Yesl Koh, Eak Kyun Shin
• Journal: International journal of cardiology (Int J Cardiol) Vol. 140 Issue 1 Pg. 73-81 (Apr 01 2010) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 19059660 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2008 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Adipokines
• Adiponectin
• Antihypertensive Agents
• Benzimidazoles
• Biphenyl Compounds
• Cholesterol, HDL
• Tetrazoles
• Triglycerides
• Amlodipine
• Atenolol
• Ramipril
• candesartan

Topics

• Adipokines (blood)
• Adiponectin (blood)
• Adult
• Aged
• Amlodipine (pharmacology, therapeutic use)
• Antihypertensive Agents (classification, pharmacology, therapeutic use)
• Atenolol (pharmacology, therapeutic use)
• Benzimidazoles (pharmacology, therapeutic use)
• Biphenyl Compounds
• Cholesterol, HDL (blood)
• Comorbidity
• Endothelium, Vascular (drug effects)
• Female
• Humans
• Hypertension (drug therapy, epidemiology)
• Male
• Middle Aged
• Ramipril (pharmacology, therapeutic use)
• Single-Blind Method
• Tetrazoles (pharmacology, therapeutic use)
• Triglycerides (blood)