Effects of antihypertensive treatment with angiotensin II receptor blockers on lipid profile: an open multi-drug comparison trial.
BACKGROUND
Dyslipidaemia is associated with high risk for cardiovascular disease and lipid management is arguably necessary, especially in hypertensive subjects. There is an implication that angiotensin receptor blockers (ARB) are characterised by a beneficial effect on lipid profile in addition to their blood pressure lowering properties. This study was conducted to evaluate blood pressure control and the plasma lipid profile in hypertensive patients after six months' treatment with ARB.


METHODS
We studied 2438 consecutive, untreated patients with uncomplicated essential hypertension (mean blood pressure [BP] 167/100 mmHg). All patients underwent full lab and echo examination at drug-free baseline, which was repeated after at least 6 months of ARB monotherapy.


RESULTS
Overall, ARB treatment reduced BP levels significantly (p<0.0001). Evaluating lipid profile changes, a significant (p<0.0001) reduction was noted in total cholesterol (TC: from 220 +/- 39 to 216 +/- 36 mg/dL), low density lipoprotein cholesterol (LDL: from 146 +/- 35 to 141 +/- 33 mg/dL), ratio of TC to high density lipoprotein cholesterol (HDL) (from 4.80 +/- 1.35 to 4.64 +/- 1.25), apolipoprotein (Apo) B (from 129 +/- 32 to 124 +/- 28 mg/dL), and triglyceride levels (from 130 +/- 63 to 128 +/- 61 mg/dL, p=0.015), while ApoA1 and lipoprotein(a) levels were not significantly affected (149 +/- 23 vs. 149 +/- 22 and 24.9 +/- 26.3 vs. 24.7 +/- 26.4 mg/ dL, respectively, p=NS). Additionally, HDL levels increased from 48.2 +/- 12.2 to 48.8 +/- 11.9 mg/ dL, p<0.0001. According to the individual agent used, a different effect on lipid indices was observed.


CONCLUSIONS
ARB antihypertensive therapy may have a uniquely beneficial metabolic effect in addition to blood pressure lowering.
Hypertension Unit, 1st Cardiology Department, Athens University, Hippokration Hospital, Greece. kyvelou113@yahoo.gr
Stella-Maria G
SM
Kyvelou
Gregory P
GP
Vyssoulis
Eva A
EA
Karpanou
Dionysios N
DN
Adamopoulos
Alexandra I
AI
Zervoudaki
Panagiota G
PG
Pietri
Christodoulos I
CI
Stefanadis
D000179:Acrylates / Q000494:pharmacology; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001562:Benzimidazoles / Q000494:pharmacology; D001565:Benzoates / Q000494:pharmacology; D001713:Biphenyl Compounds / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy*; D007093:Imidazoles / Q000494:pharmacology; D000077405:Irbesartan; D008019:Life Style; D008074:Lipoproteins / Q000097:blood*; D019808:Losartan / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D000077333:Telmisartan; D013777:Tetrazoles / Q000494:pharmacology; D013876:Thiophenes / Q000494:pharmacology; D014633:Valine / Q000031:analogs & derivatives / Q000494:pharmacology; D000068756:Valsartan
D000179:Acrylates; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001565:Benzoates; D001713:Biphenyl Compounds; D007093:Imidazoles; D008074:Lipoproteins; D013777:Tetrazoles; D013876:Thiophenes; C068373:eprosartan; D000068756:Valsartan; D014633:Valine; D000077405:Irbesartan; D019808:Losartan; C081643:candesartan; D000077333:Telmisartan