EFFECTS OF DIFFERENT ANTIHYPERTENSIVE DRUGS ON PLASMA-FIBRINOGEN IN HYPERTENSIVE PATIENTS

1 In order to evaluate whether treatment with different antihypertensi ve drugs would affect plasma fibrinogen levels, 118 mild to moderate e ssential hypertensive subjects, all males, aged 18 to 65 years, were r andomly treated with amlodipine 10 mg, atenolol 100 mg, hydrochlorothi azide 25 mg or lisinopril 20 mg, all given once daily for 8 weeks. 2 B efore and after 8 weeks' treatment, blood pressure (BP), heart rate (H R), fibrinogen, total cholesterol (TC), HDL-C, LDL-C, triglycerides (T G), plasma glucose, plasma uric acid, serum creatinine and serum potas sium were evaluated. 3 All four medications significantly reduced BP v alues, although the BP lowering effect of lisinopril, amlodipine and a tenolol was significantly greater compared with that of hydrochlorothi azide. 4 Plasma fibrinogen levels were unaffected by atenolol, hydroch lorothiazide and amlodipine, whereas they were significantly decreased by lisinopril (-11.2%, P = 0.002). This fibrinogen lowering effect wa s more evident in smokers (-17.7%) than in non smokers (-7.4%). 5 Aten olol and amlodipine did not significantly affect plasma lipids, hydroc hlorothiazide increased TC, LDL-C and TG and reduced HDL-C; lisinopril increased HDL-C and decreased TC and LDL-C. 6 Hydrochlorothiazide inc reased plasma glucose and uric acid concentrations, which were unaffec ted by the other drugs. The diuretic also reduced serum potassium. 7 T he results of this study indicate that lisinopril reduces levels of pl asma fibrinogen and confirm that different antihypertensive drugs may elicit different metabolic effects, which may variously influence the overall risk profile of the hypertensive patients.