To evaluate the clinical effectiveness of Angiotensin II receptor blocker Valsartan in hypertension (Ht) associated with purine and carbohydrate metabolism disorders.Design and Method:
45 men 40–70 years old with Ht grade 1–2 connected with uric acid level rise were investigated. 27 of them have glucose intolerance. Valsartan 80–160 mg daily as monotherapy or in combine antihypertensive therapy was administered to all pts in 12 weeks. Hemodynamic values including 24-hours blood pressure monitoring (BPM-24), biochemical values, HOMA-index, and 24-your urate excretion were evaluated.Results:
Good Valsartan's antihypertensive effect manifested office BP reducing from 161 ± 8/95 ± 5 to 122 ± 5/76 ± 4 mmHg (p < 0,001) and adequate BP control after 12 weeks treatment in 34 (75,6%) pts. Positive changes in lipid metabolism manifested significantly total cholesterol levels decreasing and high density lipoproteins levels increasing. НОМА-index levels decreased from 2,6 ± 0,1 to 2,2 ± 0,1. Number of glucose intolerance pts reduced from 27 to 9, and number of insulin resistance pts (НОМА-index > 2,77) reduced from 21 (46,7%) to 14 (31,1%). BPM-24 – data revealed significantly reducing 24-your systolic and diastolic BP levels, and systolic and diastolic measurement indices. The number of “dipper”- pts increased at 68,8%. Mean heart rate decreases from 77 ± 2 to 70 ± 1 b/min (p < 0,05). The number of uric acid high levels pts decreases at 22,2%, and mean uric acid levels decreases from 547 ± 12 to 471 ± 14 mkM/l (p < 0,01) without anti-gout agents prescribing. Urate excretion mean levels also increased. The number of glomerular hyperfiltration pts decreased at 13,4%.Conclusions:
Valsartan's treatment associated with clearly antihypertensive effect in mono- and combined therapy and positive influence on purine, carbohydrate metabolism and insulin resistance. Good tolerance and effective interaction Valsartan with other antihypertensive agents were noted. Our data revealed that Valsartan may be successfully used as choice agent in Ht associated with purine and carbohydrate metabolism disorders.