Gabriela Cioca 1, Minerva Boitan 1, Alina Zaharie 2, L. Safta 3
1 Faculty of Medicine “Victor Papilian” Sibiu
2 Emergency County Hospital of Sibiu
3 University of Medicine “Iuliu Haţieganu” Cluj-Napoca
Abstract
Background. The past decade has shown an increase in the relevance of inflammation and its mediators in vascular biology. It is more likely that the inflammation remains one part of the complex pathophysiology linking hypertension to vascular disease. Plasma levels of circulating inflammatory molecules, such as the C-reactive protein (CRP), have been shown to be predictive of future cardiovascular disease (CVD), and drugs which modify their levels can reduce the risk of myocardial infarction and stroke. Methods. For the comparison of the efficiency of the angiotensin II converting enzyme inhibitors (ACEi) and the angiotensin II receptor antagonists (ARAs) on the plasma C-reactive protein (hs-CRP) we administered Enalaprilum or Candesartan for a period of 12 months to 64 patients with arterial hypertension degrees 1, 2 and 3. This was a comparative clinical study, open, randomized, non-interventional on parallel groups of subjects. Results. In the group treated with Candesartan (35 patients) we observed a significant decrease in the plasma level of hs-CRP from 2.29±2.39 to 1.02±0.88 mg/dl (p<0.001) and in the group treated with Enalaprilum (29 patients) the plasma hs-CRP level decreased from 3.04±2.12 to 1.70±1.87 mg/dl (p<0.001). Between the two groups we have not observed a statistically significant difference in lowering the plasma levels of hs-CRP. There were no significant correlations between hs-CRP and systolic blood pressure, diastolic blood pressure and lipoprotein levels. There was a significant correlation between initial hs-CRP and waist size (r = 0.32). Conclusions. The present results show that 12 months of Candesartan or Enalaprilum therapy improved plasmatic levels of hs-CRP. In conclusion, the angiotensin II converting enzyme inhibitors and the angiotensin II receptor antagonists have the ability to positively influence cardiovascular outcomes of essential arterial hypertension.