Pleiotropic effects of antihypertensive drugs

Omran M Alhamami, Jabbar Y AL-Mayah, Najah R AL-Mousawi, Hayder I AL-Mousawi

Abstract


The haemostatic state and the lipid profile in hypertensive patients and the effects of antihypertensive drugs on these parameters were investigated. C-reactive protein (CRP) was also measured for its great role in detecting future cardiovascular events. One hundred and one patients with essential hypertension of mild to moderate grades were included in this study. Those patients were either on antihypertensive therapy, off-treatment or they were newly diagnosed hypertensives. Forty eight normotensive subjects were selected from the general population and acted as control. Serum lipids (total cholesterol, TC; triglyceride, TG; low density lipoprotein, LDL; high density lipoprotein, HDL and very low density lipoprotein, VLDL) and haemostatic parameters (prothrombin time, PT; partial thromboplastin time, PTT and platelets count) as well as renal and hepatic functions were assessed in all hypertensive and normal subjects. CRP was also measured. A two-tailed independent t-test at  = 0.05 level of significance was used. The results indicated that the HDL is significantly lower and VLDL is significantly higher in hypertensive patients than normotensive subjects. Hypertensives on atenolol and those on diuretics have significantly higher levels of TC, TG and LDL and significantly lower HDL levels than normotensives. Hypertensive patients on captopril have significantly higher levels of HDL and significantly lower levels of TC compared with patients on atenolol. Patients with longer duration of hypertension have greater possibility of having positive CRP and patients with positive CRP have higher LDL and lower HDL levels. No significant differences were found in PT, PTT and platelets count between hypertensives and normotensives. As a conclusion, antihypertensives do have an effect on lipids and CRP, namely β-selective blockers like atenolol which may induce a shift towards a more atherogenic lipid profile. This means careful choice of antihypertensives according to comorbid disease or risk factors.

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