Association of hypertensive status and its drug treatment with lipid and haemostatic factors in middle-aged men: the PRIME Study

Aims: To assess the association of hypertensive status and antihypertensive drug treatment with lipid and haemostatic levels in middle-aged men. Methods and results: Hypertensive status, antihypertensive drug treatment, total and high-density lipoprotein (HDL) cholesterol, triglyceride, apoprot eins A-I and B, lipoparticles LpA-I, LpE:B and Lp(a), fibrinogen, plasminog en activator inhibitor-1 (PAI-1) activity and factor VII were assessed in a sample of men 50-59 years living in France (n = 7050) and Northern Ireland (n = 2374). After adjustment for age, body mass index, smoking status, edu cational level, country, alcohol drinking and hypolipidaemic drug treatment , untreated hypertensive subjects had higher levels of total cholesterol, t riglyceride, apoproteins A-I and B and PAI-I activity than normotensive sub jects. On univariate analysis, diuretics decreased total and HDL-cholestero l and apoproteins AI and B; those differences remained after multivariate a djustment. Treatment with beta-blockers decreased total and HDL-cholesterol , apoprotein A-I and LpA-I, and this effect remained after multivariate adj ustment. Calcium channel blockers decreased total cholesterol and apoprotei ns A-I and B; those differences remained significant after multivariate adj ustment. ACE inhibitors decreased total cholesterol, triglycerides, apoprot ein B and LpE:B; and this effect remained after multivariate adjustment. An alysis of the subjects on monotherapy showed beta-blockers to decrease tota l cholesterol and HDL parameters and angiotersin-converting enzyme (ACE) in hibitors to decrease low-density lipoprotein (LDL)-related parameters, whil e no effect was found for the other antihypertensive drugs. Conclusions: Hypertensive status is associated with an unfavourable lipid a nd haemostatic profile in middle-aged men. Antihypertensive treatment with beta-blockers decreases HDL parameters, whereas treatment with ACE inhibito rs appears to decrease total cholesterol and LDL-related parameters.