Association of hypertensive status and its drug treatment with lipid and haemostatic factors in middle-aged men: the PRIME study.
OBJECTIVE
To assess the association of hypertensive status and antihypertensive drug treatment with lipid and haemostatic levels in middle-aged men.


RESULTS
Hypertensive status, antihypertensive drug treatment, total and high-density lipoprotein (HDL) cholesterol, triglyceride, apoproteins A-I and B, lipoparticles LpA-I, LpE:B and Lp(a), fibrinogen, plasminogen activator inhibitor-1 (PAI-1) activity and factor VII were assessed in a sample of men 50-59 years living in France (n = 7050) and Northern Ireland (n = 2374). After adjustment for age, body mass index, smoking status, educational level, country, alcohol drinking and hypolipidaemic drug treatment, untreated hypertensive subjects had higher levels of total cholesterol, triglyceride, apoproteins A-I and B and PAI-I activity than normotensive subjects. On univariate analysis, diuretics decreased total and HDL-cholesterol and apoproteins A-I and B; those differences remained after multivariate adjustment. Treatment with beta-blockers decreased total and HDL-cholesterol, apoprotein A-I and LpA-I, and this effect remained after multivariate adjustment. Calcium channel blockers decreased total cholesterol and apoproteins A-I and B; those differences remained significant after multivariate adjustment. ACE inhibitors decreased total cholesterol, triglycerides, apoprotein B and LpE:B; and this effect remained after multivariate adjustment. Analysis of the subjects on monotherapy showed beta-blockers to decrease total cholesterol and HDL parameters and angiotensin-converting enzyme (ACE) inhibitors to decrease low-density lipoprotein (LDL)-related parameters, while no effect was found for the other antihypertensive drugs.


CONCLUSIONS
Hypertensive status is associated with an unfavourable lipid and haemostatic profile in middle-aged men. Antihypertensive treatment with beta-blockers decreases HDL parameters, whereas treatment with ACE inhibitors appears to decrease total cholesterol and LDL-related parameters.
Marques-Vidal
P
P
INSERM U518, Faculté de Médecine Purpan, Toulouse, France.
Montaye
M
M
Haas
B
B
Bingham
A
A
Evans
A
A
Juhan-Vague
I
I
Ferrières
J
J
Luc
G
G
Amouyel
P
P
Arveiler
D
D
McMaster
D
D
Ruidavets
J B
JB
Bard
J M
JM
Scarabin
P Y
PY
Ducimetière
P
P
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D004232:Diuretics / Q000627:therapeutic use; D006487:Hemostasis; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy*; D008055:Lipids / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D008076:Cholesterol, HDL; D004232:Diuretics; D008055:Lipids; D008077:Lipoproteins, LDL; D002784:Cholesterol