Effects Of Bezafibrate On Blood Pressure In Hyper-tensive Patients With Hypertriglyceridemia

OBJECTIVE: To investigate additional reduction in blood pressure after lipid-lowering treatment by bezafibrate in hypertensive patients with hypertriglyceridemia using calcium channel blockers (nifedipine), to find out factors effecting blood pressure, and to exploit the mechanism of effects of bezafibrate on blood pressure.PATIENTS AND METHODS: Fifty-eight hypertensive hypertriglyceridemic patients (after two weeks wash-out from the previous antihypertensive and lipid-lowering therapy, systolic blood pressure consistently > 140 mmHg and/or diastolic blood pressure consistently > 90 mmHg ; plasma triglyceride > 2.26 mmol/L) were enrolled in study. In random order, patients of group B (28 patients) received nifedipine and diatary control, and those of group A (30 patients) received these medications plus bezafibrate after a 8-week period of dietary intervention. The changes of blood pressure, serum lipid, insulin resistance (IR) and the levels of active endothelial factors such as nitric oxide (NO), endothelin (ET), thromboxane A; (TXA2) and prostacyclin I2 (PGb) have been examined and compared with two groups. Statistical analysis was performed through t-test or x 2 test. The relationship among blood pressure, serum lipid and other factors was tested by univariate or multivariate regression analysis.RESULTS: After 8-week treatment, the bezafibrate-treated group had a greater reduction in systolic blood pressure (SBP) (P<0.0001) , diastolic blood pressure (DBF) (P< 0.001), levels of plasma triglyceride (TG) ( P< 0.0001), total cholesterol (TC) ( P<0.05), low-density hpoprotein cholesterol (LDL-c) ( P<0.05), uric acid (UA) ( P<0.05), ET (P<0.0005) and TXB2/PGF1a (P<0.0005), and had a greater increase in insulin sensitive index (ISI) ( P<0.05) and calcitonin gene related peptide (CGRP) ( P<0.01). A greater decrease in SBP (P <0.0001) and DBP (P<0.05), and increase in CGRP (P<0.05) had been found in group B. The average DBP of group A was lowered greatly more than that of group B (P<0.05). In group A, TG (r=0.5101, P<0.005) , TC (r=0.4260, P <0.05), LDL-c (r=0.4173, P<0.05), TXB2/6-K-PGF,. (r=-0.3942, P<0.05) and ET (r=0.4559, P<0.05) are associated positively with DBP, and CGRP (r=-0.5432, P<0.005), ISI (r=-0.5597, P<0.005) are negatively associated with DBP. TG CR2=0.4651, P<0.01) is an independent effective factor of DBP. CONCLUSIONS: 1. Bezafibrate can lower diastolic blood pressure of hypertensive patients with hypertriglyceridemia, and the reduction of DBP is associated with the changes of serum TG; 2.Bezafibrate can improve the patients'IR and endothelial function, and these maybe partly explain the mechanism of bezafibrate's effects on patients'blood pressure.