Abstract 3199: Significant Differential Effects of Anti-hypertensive Drugs on Plasma Adiponectin Levels In Hypertensive Patients
Background: The Nurses’ Health Study I and II and the Health Professional Follow-up Study demonstrate beta-blockers and diuretics are independently associated with a higher risk of type 2 diabetes in patients treated by anti-hypertensive drugs. In contrast, ACE inhibitors and calcium channel blockers are not. The mechanism is not clear. Adiponectin is associated with insulin sensitivity and markedly decreased in patients with type 2 diabetes. We investigated the effects of several anti-hypertensive drugs on plasma adiponectin levels in hypertensive patients.
Methods: This was a randomized, single-blind, placebo-controlled, and parrelled study. Age, sex, and body mass index were matched. Each thirty-four patients were given placebo and atenolol 100 mg, amlodipine 10 mg, hydrochlorothiazide 50 mg, ramipril 10 mg and candesartan 16 mg, respectively once during 2 month treatment period. Data are expressed mean±SEM.
Results: When baseline values before each treatment period were compared among each treatment arm, no significant differences were noted in any of the parameters measured. Placebo did not significantly change plasma adiponectin levels relative to baseline measurements from 3.9±0.4 to 3.9±0.4 (p=0.665). Atenolol significantly reduced plasma adiponectin levels from 4.5±0.5 to 3.7±0.5 (p=0.003). Hydrochlorothiazide tended to reduce plasma adiponectin levels from 3.9±0.5 to 3.4±0.4 (p=0.087). Amlodipine did not significantly change plasma adiponectin levels from 4.5±0.5 to 4.7±0.5 (p=0.406). Ramipril significantly increased plasma adiponectin levels from 3.8±0.4 to 4.2±0.4 (p=0.038). Candesartan significantly increased plasma adiponectin levels from 4.0±0.4 to 4.6±0.5 (p=0.016). The effects of anti-hypertensive drugs on plasma adiponectin levels were significant compared with placebo (p<0.001 by ANOVA). The effects of atenolol, ramipril, and candesartan on plasma adiponectin levels were significant compared with placebo (p=0.009, 0.018, and 0.049 by t-test, respectively).
Conclusions: Significant differential effects of anti-hypertensive drugs on plasma adiponectin levels may in part explain the results of clinical trials in hypertensive patients.