The Effects Of Irbesartan Or Captopril On The Serum Levels Of P-selectin And MMP-9 In Patients With Essential Hypertension

Backgroud and Aims Endothelial dysfunction in hypertension contributes to activation of platelet. The surum levels of P-selectin are associated with endothelial injury and activation of platelet. In return, activated platelet can induce the expression and increase the activity of matix metalloproteinase(MMPs).There is growing evidence that angiotensin II (Ang II) paticipate in the development of atherosclerosis( AS) via inducing the recruitment and adhesion of platelet and the release of MMPs. Blockeade of Ang II by angiotensin-converting enzyme inhibitior(ACEI) or angiotensin II receptor antagonist (ARB) induces cardiovascular protection. However, it is unclear whether ACEI captopril or ARB irbesartan has an inhititory effect on the levels of P-selectin and MMP-9 in patients with essential hypertension (EH).The present study aims to investigate the effect of captopril or irbesartan on the levels of P-selectin and MMP-9 in patients with hypertension, so as to supply a new evidence for prevention and therapy of the AS.Methods 40 patients with hypertension and 20 healthy controls were enrolled in the present study. 40 hypertensive patients were randomly divided into 2 groups (irbesartan treatment group and captopril treatment group ).Blood pressure and the serum levels of P-selectin and MMP-9 before and after 8-week treatment were determined.Results (1) The serum levels of P-selectin and MMP-9 were markedly increased in patients with hypertension (P<0.01) (2) Treatment with captopril and irbesartan significantly decreased the serum levels of P-selectin and MMP-9 in patients with hypertension (P<0.05) . But there were no significant differences between two treatment groups (P>0.05) .(3)The serum levels of P-selectin have a positive correlation with the serum levels of MMP-9 in EH patients(r=0.443,P=0.007). Both of P-selectin and MMP-9 levels have no correlation with blood pressure.Conclusions (1) The serum levels of P-selectin and MMP-9 are markedly elevated in patients with hypertension. Additionally, the serum levels of P-selectin are positively correlated with that of MMP-9 , suggesting that there exists the development of AS in mild to moderate EH patients. (2) The elevated levels of P-selectin and MMP-9 are significantly attenuated by treatment with irbesartan and captopril in patients with hypertension,which may be a new anti-atherosclerotic mechanism of ACEI or ARB. (3) That irbesartan reduced the serum levels of P-selectin and MMP-9 is not stronger than captopril.