Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.
J Hum Hypertens. 2013 Jan;27(1):44-50. doi: 10.1038/jhh.2011.108. Epub 2011 Dec 1.
The effect of antihypertensive drugs on lipoprotein subfraction profile is still under investigation. In this study the effects of fixed combination of valsartan with either amlodipine (V-A) or hydrochlorothiazide (V-H) on low-density-lipoprotein (LDL) and high-density-lipoprotein (HDL) subfraction profile of patients with stage 2 or 3 hypertension were assessed. A total of 60 drug-naive patients were randomized to either V-A (160/5 mg, n=30) or V-H (160/12.5 mg, n=30). At baseline as well as 16 weeks post-treatment analysis of the LDL and HDL subfraction profile was conducted by using LDL Lipoprint System. Both V-A and V-H effectively reduced blood pressure (BP) to similar levels. An increase in the cholesterol concentration of small-dense LDL subfractions (by 18.2%, P<0.05) was observed in the V-H group, whereas this parameter remained unchanged in the V-A group. Therefore, mean LDL particle size was decreased in the V-H group (from 267 ± 5 to 266 ± 5Å, P<0.05). HDL-Cholesterol (HDL-C) levels were reduced by 4.7% (P<0.05) in the V-H group, mirrored by a reduction in the cholesterol mass of small and intermediate HDL particles. In conclusion, despite similar reductions in BP, V-H combination may adversely affect serum lipids as well as LDL and HDL subfraction profile as compared with V-A.
降压药物对脂蛋白亚组分谱的影响仍在研究中。本研究评估了缬沙坦分别与氨氯地平（V-A）或氢氯噻嗪（V-H）固定复方对 2 或 3 期高血压患者的低密度脂蛋白（LDL）和高密度脂蛋白（HDL）亚组分谱的影响。共 60 例未经药物治疗的患者随机分为 V-A（160/5mg，n=30）或 V-H（160/12.5mg，n=30）。在基线和治疗 16 周后，采用 LDL Lipoprint 系统分析 LDL 和 HDL 亚组分谱。V-A 和 V-H 均能有效降低血压（BP）至相似水平。V-H 组小而密 LDL 亚组分的胆固醇浓度增加（18.2%，P<0.05），而 V-A 组该参数保持不变。因此，V-H 组 LDL 颗粒平均直径减小（从 267±5 降至 266±5Å，P<0.05）。V-H 组 HDL-胆固醇（HDL-C）水平降低 4.7%（P<0.05），同时小和中等 HDL 颗粒的胆固醇质量减少。总之，尽管 BP 降低相似，但与 V-A 相比，V-H 联合可能对血清脂质以及 LDL 和 HDL 亚组分谱产生不利影响。
