open access

Vol 8, No 1 (2004)
REVIEV
Published online: 2004-01-23
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The influence of losartan and trandolapril therapy on serum glucose, insulin, homocysteine and von Willebrand factor in mild to moderate essential hypertension

Marek Kretowicz, Małgorzata Ukleja-Adamowicz, Paweł Stróżecki, Krzysztof Buczkowski, Katarzyna Klucz, Ryszard Paczuski, Grażyna Odrowąż-Sypniewska, Jacek Manitius
Nadciśnienie tętnicze 2004;8(1):45-51.

open access

Vol 8, No 1 (2004)
REVIEV
Published online: 2004-01-23

Abstract

Background Carbohydrate metabolism disturbances (CM) and endothelial dysfunction (ED) often coexist with essential arterial hypertension (EH).
Material and Methods In order to investigate the effect of AT1-antagonist losartan in a daily dose of 50 mg and ACE-inhibitor trandolapril in a daily dose of 2 mg on CM and ED in untreated EH the following were evaluated in mild to moderate EH patients during fasting: glucose, insulin, total homocysteine, HbA1c, uric acid, von Willebrand Factor (vWF:Ag), HOMA-IR, BMI and WHR and the results compared to those for matched controls. The examination was repeated after 3 months in both the groups treated.
Results A decrease in HbA1c in both groups treated suggests CM correction besides the lowering of blood pressure. There was a decrease in the vWF:Ag level in the losartan group and an increase in the vWF:Ag level in the group treated with trandolapril. This difference in vWF:Ag (known as an ED marker) may be explained by the distinct way in which the drugs under examination influenced the renin-angiotensin-aldosterone system and by the possible role of kinins, the activity of which is elevated during ACE-inhibitor treatment. The trandolapril group had a higher WHR than the losartan group when compared to controls, which implies the possibility of more severe CM due to increased abdominal adipose tissue deposit. It was also characterised by higher fasting glucose, HbA1c, total homocysteine than the losartan group when compared to controls before treatment.
Conclusions Our data may suggest that mild to moderate EH patients, even when clinically similar, may respond differently to drug treatment, which may be the result of the severity of the metabolic disturbances found in this group at the beginning of treatment.

Abstract

Background Carbohydrate metabolism disturbances (CM) and endothelial dysfunction (ED) often coexist with essential arterial hypertension (EH).
Material and Methods In order to investigate the effect of AT1-antagonist losartan in a daily dose of 50 mg and ACE-inhibitor trandolapril in a daily dose of 2 mg on CM and ED in untreated EH the following were evaluated in mild to moderate EH patients during fasting: glucose, insulin, total homocysteine, HbA1c, uric acid, von Willebrand Factor (vWF:Ag), HOMA-IR, BMI and WHR and the results compared to those for matched controls. The examination was repeated after 3 months in both the groups treated.
Results A decrease in HbA1c in both groups treated suggests CM correction besides the lowering of blood pressure. There was a decrease in the vWF:Ag level in the losartan group and an increase in the vWF:Ag level in the group treated with trandolapril. This difference in vWF:Ag (known as an ED marker) may be explained by the distinct way in which the drugs under examination influenced the renin-angiotensin-aldosterone system and by the possible role of kinins, the activity of which is elevated during ACE-inhibitor treatment. The trandolapril group had a higher WHR than the losartan group when compared to controls, which implies the possibility of more severe CM due to increased abdominal adipose tissue deposit. It was also characterised by higher fasting glucose, HbA1c, total homocysteine than the losartan group when compared to controls before treatment.
Conclusions Our data may suggest that mild to moderate EH patients, even when clinically similar, may respond differently to drug treatment, which may be the result of the severity of the metabolic disturbances found in this group at the beginning of treatment.
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Keywords

HbA1c; essential hypertension; losartan; trandolapril; von Willebrand Factor

About this article
Title

The influence of losartan and trandolapril therapy on serum glucose, insulin, homocysteine and von Willebrand factor in mild to moderate essential hypertension

Journal

Arterial Hypertension

Issue

Vol 8, No 1 (2004)

Pages

45-51

Published online

2004-01-23

Bibliographic record

Nadciśnienie tętnicze 2004;8(1):45-51.

Keywords

HbA1c
essential hypertension
losartan
trandolapril
von Willebrand Factor

Authors

Marek Kretowicz
Małgorzata Ukleja-Adamowicz
Paweł Stróżecki
Krzysztof Buczkowski
Katarzyna Klucz
Ryszard Paczuski
Grażyna Odrowąż-Sypniewska
Jacek Manitius

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