Effect of antihypertensive therapy on endothelial markers in newly diagnosed stage 1 hypertension: a randomized single-centre study.

Objective: This study was aimed to investigate the effects of olmesartan or nebivolol treatment on blood pressure and some endothelial function markers in newly diagnosed patients with stage 1 essential hypertension.

Methods: This randomized open label study included 85 newly diagnosed patients with stage 1 hypertension (50 males, mean age: 52 ± 9 years). Blood pressure, flow mediated vasodilatation (FMD) and echocardiographic measurements of the patients were taken before and 8 weeks after the beginning of treatment with olmesartan or nebivolol. Nitric oxide, plasminogen activator inhibitor 1 (PAI-1) and C reactive protein (CRP) levels measured in serum samples before and after treatment, were compared. Basal variables that can affect the antihypertensive response were evaluated by multivariate logistic regression analysis.

Results: The reduction observed in the systolic and diastolic blood pressures after antihypertensive treatment was significant (p<0.05). FMD was significantly improved after treatment in both nebivolol and olmesartan groups; however, there was no significant difference between nebivolol and olmesartan groups (p=0.6). While CRP and PAI-1 levels decreased, nitric oxide levels increased in both nebivolol and olmesartan treatment groups; but these changes were not statistically significant. No drug related complication was observed.

Conclusion: This study has indicated that olmesartan and nebivolol causes similar changes in blood pressure response, FMD and endothelial function biomarkers improved. These results suggest that antihypertensive treatment, independent of the medication used, is associated with endothelial function improvement.