P4.29 COMPARATIVE EFFECTS OF ANTIHYPERTENSIVE DRUGS ON OXIDATIVE STRESS AND INFLAMMATION

Abstract

Objective: Oxidative stress and vascular inflammation are increased in hypertension. These factors may contribute to target organ damage and increased cardiovascular risk in these patients. We studied the effect of four classes of antihypertensive drugs on oxidative stress and inflammatory markers in patients with essential hypertension. Design and method: In this double-blind placebo-controlled crossover study we randomized 41 treatment-naïve hypertensive patients to receive doxazosin 4 mg, candesartan 16 mg, bisoprolol 5 mg, isosorbide mononitrate 50 mg, and placebo daily for 6 weeks. Brachial blood pressure (BP), plasma high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), asymmetric dimethylarginine (ADMA), oxidized LDL (oxLDL), soluble intercellular adhesion molecule-1 (sICAM-1), oxLDL antibodies (OLAB), and urine 8-isoprostanes were measured after each treatment period. Results: All drugs reduced systolic, diastolic, and mean arterial pressure (p<0.001) with candesartan having the greatest effect. None of the drugs reduced inflammatory or oxidative stress markers compared to placebo. There were significant differences in between-drug analysis. Doxazosin reduced OLAB and oxLDL levels the most (p<0.05). With bisoprolol there was a trend for hsCRP and ADMA level increase compared to other drugs (p<0.01). There were no differences regarding drug effects on sICAM-1, IL-6, or 8-isoprostane levels. Changes in oxLDL and to lesser degree hsCRP and sICAM-1 levels correlated with change in BP with study drugs. Conclusions: In our study an alpha-blocker seemed to have the most favorable effect on oxidative stress and inflammatory markers while a beta-blocker had least effect. These effects are partially dependent on the BP-lowering effects of the drugs.