Effect of antihypertensive drugs on plasma adiponection and retinol binding protein 4 in elderly patients with essential hypertension / 中华老年医学杂志

ABSTRACT

Objective To explore the effects of amlodipine,perindopril and valsartan on plasma adiponectin and retinol binding protein 4 in elderly patients with essential hypertension.Methods From March 2007 to July 2010,238 elderly patients with essential hypertension were selected and 193 cases completed this study.Patients were randomly divided into 3 groupsamlodipine group (n=68),perindoprilgroup (n=60) and valsartan group (n=65).Patients in each group were treated with amlodipine,perindopril and valsartan respectively for at least 12 weeks.The changes in blood pressure,heart rate,body height,body mass index (BMI),abdominal circumference,waist circumference (WC),levels of blood lipids,plasma adiponection and retinol binding protein 4 were observed before and after treatment.Results Compared with pre-treatment,systolic blood pressure in 3 groups were significantly decreased after treatment (all P＜0.01).There were no significant differences in blood pressure among 3 groups after treatment (all P＞0.05).Compared with pre treatment,plasma adiponectin level was significantly increased in perindopril group and valsartan group after treatment [(7.4±1.8) μg/L vs.(8.3± 1.8) μg/L,(7.5±1.7) μg/L vs.(8.4±1.9)μg/L,both P＜0.01].Plasma adiponectin level was higher in perindopril group and valsartan group than in amlodipine group after treatment [(8.3±1.8) μg/L vs.(7.6±1.8) μg/L,(8.4±1.9) μg/Lvs.(7.6±1.8) μg/L,both P＜0.05].Compared with pretreatment,plasma retinol binding protein 4 level in 3 groups were all decreased after treatment,and the decrements had significant differences in perindopril group and valsartan group (both P＜0.01) but had no difference in amlodipine group (P＞0.05).Plasma adiponectin retinol binding protein 4 levels were lower in perindopril group and valsartan group than in amlodipine group after treatment[(36.6± 14.2) μg/L vs.(42.7± 13.8) μg/L,(36.3±14.1) μg/L vs.(42.7±13.8) μg/L,respectively,both P＜0.01].Conclusions Perindopril and valsartan play important roles in cardiovascular protection beyond the antihypertensive effects by increasing plasma adiponection level and decreasing plasma retinol binding protein 4 level in elderly patients with hypertension.