Fibrinolytic/hemostatic variables in arterial hypertension: Response to treatment with irbesartan or atenolol

Essential hypertension is often accompanied by abnormalities of the coagula tion/fibrinolytic system, predisposing to a procoagulant state. The aim of the present study was to compare the effects of atenolol (beta(1)-blocker a gent) and irbesartan (angiotensin II type 1 receptor antagonist) on plasma levels of hemostatic/fibrinolytic and endothelial function markers in a coh ort of previously untreated hypertensives. Fifty-four patients were randoml y assigned to atenolol 25 to 150 mg (26 patients) or irbesartan 75 to 300 m g (28 patients). The plasma levels of plasminogen activator inhibitor-1 ant igen, thrombomodulin, tissue factor pathway inhibitor antigen, fibrinogen, and factor XII were determined before and after 6 months of therapy. Age, g ender distribution, body mass index, lipid profile, and baseline values of the measured markers were similar in both groups. Baseline values for systo lic and diastolic blood pressure, as well as the reduction after treatment, were not significantly different between the two groups. Treatment with ir besartan was associated with a significant decrease in the levels of all th e parameters. Similar findings were observed in the atenolol group, except for factor XII and tissue factor pathway inhibitor levels, which were not s ignificantly decreased in this group. The reduction, however, of fibrinogen , plasminogen activator inhibitor-1, and thrombomodulin was significantly g reater in the irbesartan than in the atenolol group. In conclusion, the res ults indicated that, despite an equally controlled blood pressure, 6-month therapy with irbesartan was associated with a more favorable modification o f hemostatic/fibrinolytic status than atenolol. (C) 2000 American Journal o f Hypertension, Ltd.