Vnitr Lek 2010, 56(12):1210-1216

Markers of endothelial function in the early stages of essential hypertension and the effect of antihypertensive therapy

A. Remková^1,*, M. Remko^2,1

¹ Centrum hemostázy a trombózy, HemoMedika Bratislava s.r.o., Bratislava, Slovenská republika, odborný garant prof. MUDr. Anna Remková, PhD., DrSc.

² Farmaceutická fakulta UK Bratislava, Slovenská republika, dekan prof. PharmDr. Ján Kyselovič, PhD.

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.

Subjects and 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.

Conclusion:
Our results demonstrate that antihypertensive treatment by perindopril or rilmenidine has a favourable affect on some endothelial markers.

Keywords: hypertension; endothelium; perindopril; telmisartan; rilmenidine

Received: May 3, 2010; Accepted: August 7, 2010; Published: December 1, 2010  Show citation