ABSTRACT

Effects of Trandolapril and Losartan on Vascular and Metabolic Parameters in Primary Hypertension In primary hypertension (HT), targed organs damaged by atherosclerosis. The renin-angiotensin system (RAS) play an important role, not only in the regulation of blood pressure, but also metabolic disturbances, and pathogenesis of atherosclerosis. The aim of our study was to investigate the vascular and metabolic parameters in HT patients in an early period where no functional disorders were noticed, and then to evaluate the effects of six months trandolapril and losartan therapy. 63 (27 F, 36 M) HT patients (mean systolic blood pressure 158.9± 11.4 mmHg, mean diastolic blood pressure 99.7± 6.9 mmHg, duration of HT 31.6 ± 38.5 months) who did not developed organ complications, and 41 healthy subjects (17 F, 24 M) were enrolled the study. In patients group; von Willebrand Factor (vWF) activity (P=0.022), fibrinogen (P=0.027), platelet count (P=0.024), uric acid (UA, P=0.041), insulin (P=0.011), insulin resistance (IR, P=0.005), total cholesterol (TC, P=0.020), triglicerides (TG, P=0.003) were significantly higher than the control group’s. Hypertensive retinopathy were recognized in 71% of HT patients. After six monts of treatment, both drugs reduced blood pressure to a comprable degree. Trandolapril therapy led to a significant decrease in platelet count (P=0.006), vWF (P=0.003), insulin (P=0.005), and IR (P=0.005). Platelet count (P=0.006), uric acid (P=0.000), insulin (P=0.011), IR (P=0.012), TC (P=0.011), TG (P=0.033) levels were seen to be significantly decreased with losartan treatment. Our results show that; in the patients group with short hypertension period and whom 84 % were mild to moderately hypertensive, a significant vascular interaction and metabolic disturbances were found. Positive vascular effect and positive metabolic effect were much more significant in trandolapril and losartan respectively.