Skip to main content
NCBI home page
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1995 May;39(5):471–476. doi: 10.1111/j.1365-2125.1995.tb04482.x

Effects of different antihypertensive drugs on plasma fibrinogen in hypertensive patients.

R Fogari 1, A Zoppi 1, G D Malamani 1, G Marasi 1, A Vanasia 1, G Villa 1
PMCID: PMC1365052  PMID: 7669481

Abstract

1. In order to evaluate whether treatment with different antihypertensive drugs would affect plasma fibrinogen levels, 118 mild to moderate essential hypertensive subjects, all males, aged 18 to 65 years, were randomly treated with amlodipine 10 mg, atenolol 100 mg, hydrochlorothiazide 25 mg or lisinopril 20 mg, all given once daily for 8 weeks. 2. Before and after 8 weeks' treatment, blood pressure (BP), heart rate (HR), fibrinogen, total cholesterol (TC), HDL-C, LDL-C, triglycerides (TG), plasma glucose, plasma uric acid, serum creatinine and serum potassium were evaluated. 3. All four medications significantly reduced BP values, although the BP lowering effect of lisinopril, amlodipine and atenolol was significantly greater compared with that of hydrochlorothiazide. 4. Plasma fibrinogen levels were unaffected by atenolol, hydrochlorothiazide and amlodipine, whereas they were significantly decreased by lisinopril (-11.2%, P = 0.002). This fibrinogen lowering effect was more evident in smokers (-17.7%) than in non smokers (-7.4%). 5. Atenolol and amlodipine did not significantly affect plasma lipids, hydrochlorothiazide increased TC, LDL-C and TG and reduced HDL-C; lisinopril increased HDL-C and decreased TC and LDL-C. 6. Hydrochlorothiazide increased plasma glucose and uric acid concentrations, which were unaffected by the other drugs. The diuretic also reduced serum potassium. 7. The results of this study indicate that lisinopril reduces levels of plasma fibrinogen and confirm that different antihypertensive drugs may elicit different metabolic effects, which may variously influence the overall risk profile of the hypertensive patients.

Full text

PDF
471

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ambrosioni E., Borghi C., Costa F. V. Captopril and hydrochlorothiazide: rationale for their combination. Br J Clin Pharmacol. 1987;23 (Suppl 1):43S–50S. doi: 10.1111/j.1365-2125.1987.tb03121.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ames R. Effects of diuretic drugs on the lipid profile. Drugs. 1988;36 (Suppl 2):33–40. doi: 10.2165/00003495-198800362-00007. [DOI] [PubMed] [Google Scholar]
  3. CLAUSS A. Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens. Acta Haematol. 1957 Apr;17(4):237–246. doi: 10.1159/000205234. [DOI] [PubMed] [Google Scholar]
  4. Caimi G., Catania A., Frazzetta F., Capobianco D., Sarno A. Essential hypertension. The behaviour of the haemorheological determinants and their trends during beta-blocker treatment. Jpn Heart J. 1983 Sep;24(5):723–729. doi: 10.1536/ihj.24.723. [DOI] [PubMed] [Google Scholar]
  5. Costa F. V., Borghi C., Mussi A., Ambrosioni E. Hypolipidemic effects of long-term antihypertensive treatment with captopril. A prospective study. Am J Med. 1988 Mar 11;84(3A):159–161. doi: 10.1016/0002-9343(88)90226-4. [DOI] [PubMed] [Google Scholar]
  6. Elwood P. C., Yarnell J. W., Pickering J., Fehily A. M., O'Brien J. R. Exercise, fibrinogen, and other risk factors for ischaemic heart disease. Caerphilly Prospective Heart Disease Study. Br Heart J. 1993 Feb;69(2):183–187. doi: 10.1136/hrt.69.2.183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ernst E. Fibrinogen. BMJ. 1991 Sep 14;303(6803):596–597. doi: 10.1136/bmj.303.6803.596. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Ernst E. Lowering the plasma fibrinogen concentration with drugs. Clin Pharm. 1992 Nov;11(11):968–971. [PubMed] [Google Scholar]
  9. Ernst E., Resch K. L. Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the literature. Ann Intern Med. 1993 Jun 15;118(12):956–963. doi: 10.7326/0003-4819-118-12-199306150-00008. [DOI] [PubMed] [Google Scholar]
  10. Feher M. D., Rampling M. W., Sever P. S., Elkeles R. S. Diabetic hypertension--the importance of fibrinogen and blood viscosity. J Hum Hypertens. 1988 Aug;2(2):117–122. [PubMed] [Google Scholar]
  11. Fogari R., Zoppi A., Pasotti C., Poletti L., Tettamanti F., Maiwald C. Effects of different beta-blockers on lipid metabolism in chronic therapy of hypertension. Int J Clin Pharmacol Ther Toxicol. 1988 Dec;26(12):597–604. [PubMed] [Google Scholar]
  12. Friedewald W. T., Levy R. I., Fredrickson D. S. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 Jun;18(6):499–502. [PubMed] [Google Scholar]
  13. Herrmann J. M., Mayer E. O. A long-term study of the effects of celiprolol on blood pressure and lipid-associated risk factors. Am Heart J. 1988 Nov;116(5 Pt 2):1416–1421. doi: 10.1016/0002-8703(88)90133-0. [DOI] [PubMed] [Google Scholar]
  14. Kannel W. B., D'Agostino R. B., Belanger A. J. Fibrinogen, cigarette smoking, and risk of cardiovascular disease: insights from the Framingham Study. Am Heart J. 1987 Apr;113(4):1006–1010. doi: 10.1016/0002-8703(87)90063-9. [DOI] [PubMed] [Google Scholar]
  15. Kannel W. B. Hypertension and other risk factors in coronary heart disease. Am Heart J. 1987 Oct;114(4 Pt 2):918–925. doi: 10.1016/0002-8703(87)90588-6. [DOI] [PubMed] [Google Scholar]
  16. Kannel W. B., Wolf P. A., Castelli W. P., D'Agostino R. B. Fibrinogen and risk of cardiovascular disease. The Framingham Study. JAMA. 1987 Sep 4;258(9):1183–1186. [PubMed] [Google Scholar]
  17. Kaplan N. M. Importance of coronary heart disease risk factors in the management of hypertension. An overview. Am J Med. 1989 Jan 23;86(1B):1–4. doi: 10.1016/0002-9343(89)90119-8. [DOI] [PubMed] [Google Scholar]
  18. Landolfi R., De Cristofaro R., De Candia E., Rocca B., Bizzi B. Effect of fibrinogen concentration on the velocity of platelet aggregation. Blood. 1991 Jul 15;78(2):377–381. [PubMed] [Google Scholar]
  19. Lee A. J., Lowe G. D., Woodward M., Tunstall-Pedoe H. Fibrinogen in relation to personal history of prevalent hypertension, diabetes, stroke, intermittent claudication, coronary heart disease, and family history: the Scottish Heart Health Study. Br Heart J. 1993 Apr;69(4):338–342. doi: 10.1136/hrt.69.4.338. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Lee A. J., Smith W. C., Lowe G. D., Tunstall-Pedoe H. Plasma fibrinogen and coronary risk factors: the Scottish Heart Health Study. J Clin Epidemiol. 1990;43(9):913–919. doi: 10.1016/0895-4356(90)90075-z. [DOI] [PubMed] [Google Scholar]
  21. Letcher R. L., Chien S., Laragh J. H. Changes in blood viscosity accompanying the response to prazosin in patients with essential hypertension. J Cardiovasc Pharmacol. 1979 Nov-Dec;1(6 Suppl):S8–20. [PubMed] [Google Scholar]
  22. Lindholm L. H. Cardiovascular risk factors and their interactions in hypertensives. J Hypertens Suppl. 1991 Dec;9(3):S3–S6. [PubMed] [Google Scholar]
  23. Lowe G. D., Drummond M. M., Lorimer A. R., Hutton I., Forbes C. D., Prentice C. R., Barbenel J. C. Relation between extent of coronary artery disease and blood viscosity. Br Med J. 1980 Mar 8;280(6215):673–674. doi: 10.1136/bmj.280.6215.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Meade T. W., Mellows S., Brozovic M., Miller G. J., Chakrabarti R. R., North W. R., Haines A. P., Stirling Y., Imeson J. D., Thompson S. G. Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet. 1986 Sep 6;2(8506):533–537. doi: 10.1016/s0140-6736(86)90111-x. [DOI] [PubMed] [Google Scholar]
  25. Mehrotra T. N., Mital H. S., Singh V. S., Kumar A., Sinha A. K., Raka M. S. Platelet adhesiveness, plasma fibrinogen and fibrinolytic activity in angina pectoris before and after propranolol therapy. J Assoc Physicians India. 1983 Oct;31(10):641–643. [PubMed] [Google Scholar]
  26. Ott E., Fazekas F., Tschinkel M., Bertha G., Lechner H. Rheological aspects of cerebrovascular disease. Eur Neurol. 1983;22 (Suppl 1):35–37. doi: 10.1159/000115609. [DOI] [PubMed] [Google Scholar]
  27. Pollare T., Lithell H., Berne C. A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension. N Engl J Med. 1989 Sep 28;321(13):868–873. doi: 10.1056/NEJM198909283211305. [DOI] [PubMed] [Google Scholar]
  28. Poulter N. Management of multiple risk factors for coronary heart disease in patients with hypertension. Am Heart J. 1991 Jan;121(1 Pt 2):246–250. doi: 10.1016/0002-8703(91)90851-8. [DOI] [PubMed] [Google Scholar]
  29. Röschlau P., Bernt E., Gruber W. Enzymatische Bestimmung des Gesamt-Cholesterins im Serum. Z Klin Chem Klin Biochem. 1974 Sep;12(9):403–407. [PubMed] [Google Scholar]
  30. Sadoshima S., Tanaka K. Fibrinogen and low density lipoprotein in the development of cerebral atherosclerosis. Atherosclerosis. 1979 Oct;34(2):93–103. doi: 10.1016/0021-9150(79)90133-3. [DOI] [PubMed] [Google Scholar]
  31. Salmasi A. M., Salmasi S., MacDonald G., Nicolaides A. N. Improvement of silent myocardial ischaemia and reduction of plasma fibrinogen during nisoldipine therapy in occult coronary arterial disease. Int J Cardiol. 1991 Apr;31(1):71–80. doi: 10.1016/0167-5273(91)90270-y. [DOI] [PubMed] [Google Scholar]
  32. Stone M. C., Thorp J. M. Plasma fibrinogen--a major coronary risk factor. J R Coll Gen Pract. 1985 Dec;35(281):565–569. [PMC free article] [PubMed] [Google Scholar]
  33. Weidmann P., Uehlinger D. E., Gerber A. Antihypertensive treatment and serum lipoproteins. J Hypertens. 1985 Aug;3(4):297–306. doi: 10.1097/00004872-198508000-00001. [DOI] [PubMed] [Google Scholar]
  34. Welin L., Svärdsudd K., Wilhelmsen L., Larsson B., Tibblin G. Analysis of risk factors for stroke in a cohort of men born in 1913. N Engl J Med. 1987 Aug 27;317(9):521–526. doi: 10.1056/NEJM198708273170901. [DOI] [PubMed] [Google Scholar]
  35. Wilhelmsen L., Svärdsudd K., Korsan-Bengtsen K., Larsson B., Welin L., Tibblin G. Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med. 1984 Aug 23;311(8):501–505. doi: 10.1056/NEJM198408233110804. [DOI] [PubMed] [Google Scholar]
  36. Wilkes H. C., Kelleher C., Meade T. W. Smoking and plasma fibrinogen. Lancet. 1988 Feb 6;1(8580):307–308. doi: 10.1016/s0140-6736(88)90398-4. [DOI] [PubMed] [Google Scholar]
  37. Yarnell J. W., Baker I. A., Sweetnam P. M., Bainton D., O'Brien J. R., Whitehead P. J., Elwood P. C. Fibrinogen, viscosity, and white blood cell count are major risk factors for ischemic heart disease. The Caerphilly and Speedwell collaborative heart disease studies. Circulation. 1991 Mar;83(3):836–844. doi: 10.1161/01.cir.83.3.836. [DOI] [PubMed] [Google Scholar]
  38. di Minno G., Mancini M. Drugs affecting plasma fibrinogen levels. Cardiovasc Drugs Ther. 1992 Feb;6(1):25–27. doi: 10.1007/BF00050913. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES