Effects of allopurinol on arterial blood pressure and pulse wave velocity depending on hypouricemic effect

Abstract

Background Some studies show that allopurinol reduces blood pressure in adolescents with newly diagnosed hypertension, decreases aortic pulse wave velocity (PWV) and improves endothelial function in hypertensives. It was not the case with uricosuric agents. It is possible that there may be vasoprotective mechanism of allopurinol which is independent from its hypouricemic effect. To determine effects of allopurinol on arterial blood pressure and PWV depending on hypouricemic effect in treated hypertension.
Material and methods The study was performed between 2006 and 2008 in the Department of Hypertension, Angiology and Internal Medicine of Poznan University of Medical Sciences. Whenever there was any doubt about a possible secondary cause of arterial hypertension the patients were hospitalized in the Department, where further diagnostic procedures were performed. 66 patients with treated arterial hypertension aged 30 to 70 (mean age 46.17 ± 10.89) have been studied. After 8 weeks of antihypertensive therapy, allopurinol 150 mg daily was added for 2 months. Clinic blood pressure, ABPM and PWV measurements were done before and after alloprurinol treatment. Patients are diveded in two groups depending on hypouricemic effect. Group A presents stronger hypouricemic effect (median over > 0.835), group B presents poor hypouricemic effect (median ≤ 0.835).
Results After allopurinol treatment changes in the office blood pressure in groups A and B were following: ∆SBP +0.01, ∆SBP +0.78 (p = 0.65), ∆DBP +0.43 and ∆DBP +0.83 (p = 0.78), ∆PP -0.43 and ∆PP -0.04 (p = 0.79). After allopurinol treatment PWV in group A decreased from 11.26 ± 1.9 m/s (∆PWV -1.06) to 10.21 ± 1.7 m/s and group B from 11.01 ± 1.33 m/s to 10.24 ± 1.04 m/s (∆PWV -0.77). The degree of improvement in pulse wave velocity was not correlated with hypouricemic effect of allopurinol (p = 0.24). Although, there was observed the tendency to greater PWV improvement in case of greater changes in urate levels.
Conclusions
1. There were no significant changes in blood pressure after allopurinol treatment regardless of the extent of lowering uric acid level.
2. The degree of improvement in PWV was not correlated with hypouricemic effect of allopurinol. Although, there was observed the tendency to greater PWV improvement in case of greater changes in urate levels.
Arterial Hypertension 2010, vol. 14, no 5, pages 367-374.