Abstract 472: Effect of Different Doses of Angiotensin II Receptor Blockers on Adipokine Levels in Hypertensive Patients

Abstract

The present study was designed to determine the effect of different doses of the angiotensin II receptor blocker, candesartan, on circulating adiponectin and leptin levels as well as plasma leptin adiponectin ratio (LAR) in hypertensive patients with multiple cardiovascular risk factors. 69 hypertensive patients were randomized to 3 groups: group 1 included patients treated with high doses of Candesartan (32mg), group 2 included patients treated with conventional doses of Candesartan (16mg), group 3 included patients that received antihypertensive treatment other that ARBs or ACEIs. Patients were evaluated for lipid profile, HbA1C, insulin, C-peptide, CRP, aldosterone, renin,HOMA-IR, leptin , adiponectin and LAR. Baseline adiponectin, leptin and LAR levels did not differ significantly between the three groups. After six months of treatment LAR was significantly higher in group 3 than group 1 (p=0.007) or group 2 (p=0.023). Marginal across-group differences were detected for post-treatment circulating adiponectin level (p=0.064). Univariate GLM analysis of posttreatment LAR detected significant by-group differences even after adjustment for age, sex, baseline values of LAR and blood pressure. In this model, group was the only significant predictor of LAR after controlling for these variables. Treatment with high doses of angiotensin II receptor blocker, candesartan, is associated with significantly reduced LAR and marginally increased circulating adiponectin levels in hypertensive patients with multiple cardiovascular risk factors.