Effects of valsartan and indapamide on plasma cytokines in essential hypertension / 中南大学学报(医学版)

ABSTRACT

Objective To investigate and compare the effect of valsartan and indapamide on inflammatory cytokines in hypertension. Methods Forty-one untreated patients with mild to moderate hypertension and 20 age- and sex-matched normotensives were enrolled in this study. Hypertensives were treated with indapamide 1.5 mg/d (n=20) or valsartan 80 mg/d (n=21) for 4 weeks, and blood samples for determining monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 (MIP-1α), sP-selectin, asymmetric dimethylarginin (ADMA), angiotensin Ⅱ (AngⅡ), and 6-keto-PGF1α were collected before the treatment and 4 weeks after the treatment. Results Hypertensives exhibited significantly higher blood pressure, as well as elevated plasma levels of MCP-1, MIP-1α, sP-selectin and serum level of ADMA compared with the normotensives. Nevertheless, there was no significant difference in serum 6-keto-PGF1α and AngⅡ between the hypertensives and the normotensives. After the treatment with indapamide or valsartan for 4 weeks, both the systolic and diastolic blood pressures, though still higher than those of the normotensives, decreased markedly. After the treatment with indapamide for 4 weeks, MCP-1, MIP-1α and sP-selectin slightly decreased, but not statistically significant (P＞0.05). Those cytokines decreased significantly after being treated with valsartan for 4 weeks [(19.16±3.11) pg/mL vs (16.08±2.67) pg/mL, P＜0.05; (27.74±8.36) pg/mL vs (17.64±7.59) pg/mL, P＜0.05; (2.67±3.18) pg/mL vs (6.15±2.94) pg/mL, P＜0.01]. In the 2 treatment groups, 6-keto-PGF1α markedly increased [(61.96±20.81) pg/mL vs (96.72±25.89) pg/mL, P＜0.05; (63.25±16.92) pg/mL vs (143.22±43.45) pg/mL, P＜0.01]; ADMA decreased significantly [(1.35±0.74) pg/mL vs (0.98±0.56) μmol/L, P＜0.05; (1.31±0.68) pg/mL vs (0.71±0.52) μmol/L, P＜0.01]. Though AngⅡ slightly increased, no statistical significance was found (P＞0.05). Conclusion The levels of MCP-1, MIP-1α, sP-selectin and ADMA were elevated in mild to moderate hypertensives. Valsartan and indapamide have similar blood pressure lowering effect. Valasartan exerts more significant effect on cytokines than indapamide does.