The Impact of Trandolapryl on Some Metabolic Disturbances and Endothelium Dysfunction in Non-treated Essential Hypertensive Patients

Abstract

Background Essential hypertension usually coexists with insulin resistance, which is a key factor for increased sympathetic nervous system activity, visceral obesity, composed metabolic disturbances and endothelial dysfunction. The aim of the study was to evaluate the impact of trandolapril on metabolic disorders and endothelial injury.

Material and methods We examined 13 ambulatory patients with non-treated essential hypertension. The control group was of 14 healthy volunteers matched with age and sex. The anthropometric parameters were obtained. The 24 hour urine collection was assayed for albuminuria, creatinine and NAG excretion. The next day fasting blood was withdrawn for biochemistry, insulin, thrombomodulin, tissue plasminogen activator and vWF:Ag. The examination was repeated after 3 months of trandolapril oral 2 mg per day therapy.

Results The hypertensive group was characterized with a number of abnormalities, which stand for polymetabolic syndrome. After 3 months therapy the significant decrease of HbA1c (%) (6,01 ± 0,45 vs. 5,66 ± 0,41; p < 0,05) and increase of vWF:Ag (%) (148,08 ± 65,10 vs. 306,77 ± ± 146,63; p < 0,01) were observed.

Conclusions Our study suggests the advantage of trandolapril monotherapy on carbohydrate metabolism seen in polymetabolic syndrome but not on endothelial function despite satisfactory blood pressure control. We observed significant increase of vWF:Ag level which may be a local effect of ACE inhibitor on already injured endothelium.