Angiotensin receptor blockers (ARB) may be an appropriate first-line agent for hypertensive women with metabolic syndrome (MetS) because they have no metabolic side-effects and the activation of renin-angiotensin-aldosterone system is suggested as one possible mechanism of postmenopausal hypertension. This study aimed to investigate the short-term changes of metabolic syndrome and blood pressure (BP) in hypertensive women treated with fimasartan, a new ARB.Design and Method:
Among patients with hypertension enrolled in K-Mets Study, 777 women, with fimasartan as a first antihypertensive drug and 3 months follow-up data, were selected. Diabetic patients were excluded. MetS defined by ATP criteria was found in 370 (48%) patients. They were divided into two groups according to metabolic components after 3 months: 280 patients with MetS (group 1; 56.4 ± 10.0 years), and 90 patients without MetS (group 2; 54.1 ± 8.9 years).Results:
Baseline weight, body mass index, and waist circumference (AC) were higher in group 1, but menopausal status, fasting blood glucose (FBS), HbA1c, HOMA index, clinic BP, home BP and day-to-day BP variability were not different between two groups. After 3 month, clinic BP, home BP and day-to-day BP variability were effectively lowered in both groups, but changes of them were not different in both groups. Among metabolic criteria, FBS, HDL-cholesterol, or triglyceride was dramatically decreased in group 2 (baseline; 56%, 46%, and 62%, 3 month; 5%, 16%, and 6%, respectively). They were not changed in group 1. HOMA index was declined in group 2, but significantly inclined in group 1 (from 3.79 ± 4.77 to 4.80 ± 6.33, p < 0.001).Conclusions:
Baseline lower BMI and AC, but neither change of BP nor BP variability after antihypertensive treatment with ARB, were associated with the improvement of metabolic syndrome in women, which was mainly due to favorable changes of blood glucose and lipid levels.