[Markers of endothelial function in the early stages of essential hypertension and the effect of antihypertensive therapy].
OBJECTIVE
Endothelial abnormalities appear to play a role in the pathogenesis of atherosclerotic/atherothrombotic complications of hypertension. They may contribute to the increased risk and severity of target organ damage. The aim of the study was to investigate the endothelial markers in patients at the early stages of mild-to-moderate untreated hypertension with low-to-moderate added risk, and the effect of antihypertensive therapy by perindopril, telmisartan or rilmenidine on endothelial function.


METHODS
The measurements were carried out in 54 previously untreated hypertensive patients before and after one month of antihypertensive therapy by perindopril-arginine (5 mg once daily, n = 20), telmisartan (40 mg once daily, n = 16), rilmenidine (1 mg once daily, n = 18) or after placebo administration (n = 23). A population of 50 healthy normotensive subjects of similar sex, age and ethnic origin was also examined. Plasma thrombomodulin (TM) and von Willebrand factor (vWF) measurements were used as indicators of endothelial dysfunction.


RESULTS
In untreated hypertensive patients compared with a control group of healthy subjects a significant increase of plasma vWF (86.26 +/- 26.18 IU/dl against 69.14 +/- 18.74 IU/dl, P < 0.001) and TM (35.98 +/- 12.98 ng/ml against 29.34 +/- 9.18 ng/ml, P < 0.01) was found. BP was reduced (P < 0.001) or normalized due to each therapy. No significant changes of endothelial markers after placebo administration were found. A decrease of plasma vWF antigen level after 1 month of therapy by perindopril (from 81.93 +/- 22.07 to 72.88 +/- 23.26 IU/dl, P < 0.05) or rilmenidine (from 100.6 +/- 26.09 to 86.07 +/- 27.66 IU/dl, P < 0.05) was observed. No significant changes of vWF antigen levels were found after telmisartan therapy. We failed to find any changes of plasma TM due to any therapy.


CONCLUSIONS
Our results demonstrate that antihypertensive treatment by perindopril or rilmenidine has a favourable affect on some endothelial markers.
Centrum hemostázy a trombózy, HemoMedika Bratislava s.r.o., Bratislava, Slovenská republika. remkova@gmail.com
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Remková
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Remko
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D000959:Antihypertensive Agents