Antagonists of the renin-angiotensin system, such as
angiotensin type 1 (AT(1)) receptor inhibitors and
angiotensin-converting enzyme inhibitors, are becoming increasingly popular agents in treating patients with systemic
hypertension and minimizing organ damage. In the present study, we compared the effects of
eprosartan, an AT(1) receptor inhibitor, with the
diuretic hydrochlorothiazide in a group of newly diagnosed hypertensive patients with multiple risk factors for
atherosclerosis. The subjects were monitored and tested at 0 and 4 weeks to determine their individual effects on vascular and inflammatory markers. Although blood pressure reduction was comparable between the 2 agents, there were notable differences in their effects on markers of
inflammation and oxidation. We observed a 28% reduction in neutrophil
superoxide anion generating capacity, a 34% reduction in soluble
monocyte chemotactic protein-1, and a 35% reduction in soluble
vascular cell adhesion molecule with
eprosartan therapy (all p <0.05 from the start of
therapy). In addition,
eprosartan showed further benefit in its ability to increase
low-density lipoprotein oxidation lag time, suggesting an increased resistance to oxidation and/or modification of
low-density lipoprotein. Although
hydrochlorothiazide was effective in blood pressure reduction, there were no significant changes in any of the above parameters after 4 weeks of treatment. These findings suggest that
eprosartan, an AT(1) receptor inhibitor, effectively reduces systemic blood pressure and, compared with
hydrochlorothiazide, suggests additional benefits in the vasculature by inhibiting mechanisms of
inflammation and oxidation.