Effect of candesartan monotherapy on lipid metabolism in patients with hypertension: a retrospective longitudinal survey using data from electronic medical records

Cardiovascular Diabetology

Original Investigation

Masayoshi Soma¹  Satoshi Asai²  Yasuo Takahashi²  Yayoi Nishida²  Noboru Kitamura³  Tomohiro Nakayama⁴ 

[1] Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, 30-1 Oyaguchi-Kamimachi, 173-8610, Itabashi-ku, Tokyo, Japan;Division of Genomic Epidemiology and Clinical Trials, Advanced Medical Research Center, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, 173-8610, Itabashi-ku, Tokyo, Japan;Division of Clinical Trial Management, Advanced Medical Research Center, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, 173-8610, Itabashi-ku, Tokyo, Japan;Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, 30-1 Oyaguchi-Kamimachi, 173-8610, Itabashi-ku, Tokyo, Japan;Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, 173-8610, Itabashi-ku, Tokyo, Japan;

关键词: Propensity Score;    High Density Lipoprotein Cholesterol;    Candesartan;    Candesartan Cilexetil;    High Density Lipoprotein Cholesterol Level;   

DOI  :  10.1186/1475-2840-9-38

 received in 2010-05-27, accepted in 2010-08-16,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundStudies focusing on the add-on effects of angiotensin II type 1 receptor blockers (ARBs) other than their antihypertensive effect are receiving attention. However, the effects of prolonged administration of ARBs on lipid metabolism in clinical cases are unclear. Our aims were to survey the changes in plasma lipid profile in patients with hypertension over a one-year period, and to examine the correlations between these values and the time after the start of ARB monotherapy with candesartan.MethodsWe carried out candesartan monotherapy in patients with mild to moderate hypertension and examined the longitudinal changes in plasma lipid profile. Data from 405 patients for triglyceride (TG), 440 for total cholesterol (TC), 313 for high density lipoprotein cholesterol (HDL-C) and 304 for low density lipoprotein cholesterol (LDL-C) were obtained from the electronic medical records (EMRs) in the Clinical Data Warehouse (CDW) of Nihon University School of Medicine (NUSM). The inverse probability of treatment weighting (IPTW) method (calculated from the inverse of the propensity score) was used to balance the covariates and reduce bias in each treatment duration. Linear mixed effects models were used to analyse the relationship between these longitudinal data of blood examinations and covariates of patient sex, age, diagnosis of diabetes mellitus (DM) and duration of candesartan monotherapy.ResultsPlasma HDL-C level was associated with sex, duration of treatment, and interaction of sex and treatment duration, but not with age or diagnosis of DM. HDL-C level was significantly decreased during the 6~9 months period (p = 0.0218) compared with baseline. TG and TC levels were associated with sex, but not with age, diagnosis of DM or treatment duration. LDL-C level was not associated with any covariate. Analysis of the subjects divided by sex revealed a decrease in HDL-C in female subjects (during the 6~9 months period: p = 0.0054), but not in male subjects.ConclusionsOur study revealed that administration of candesartan slightly decreased HDL-C in female subjects. However, TG, TC and LDL-C levels were not influenced by candesartan monotherapy. Candesartan may be safely used for patients with hypertension with respect to lipid metabolism, because the effect of candesartan on lipids may be small.

【 授权许可】

Unknown   
© Nishida et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.