APPS November 2002 Meeting Abstract 2435

A number of studies have demonstrated an increase in plasma homocysteine (tHCY) levels in hypertensive patients, whether asymptomatic^1,2 or with cerebral infarction.³ Elevated plasma tHCY is an independent risk factor for vascular diseases.⁴ Irbesartan, an angiotensin II (AII) antagonist, is a newer class of antihypertensive agents that inhibits the renin angiotensin system by selectively blocking the AT₁ subtype of AII receptors.^5,6 Nevertheless, its effects on plasma tHCY in hypertensive patients remains to be established. The associations of tHCY levels with possible confounding factors were also evaluated. A non-randomized, run-in placebo followed by a 3-month follow up clinical study was carried out in 33 subjects (20 men, 13 women) with uncomplicated mild to moderate essential hypertension. The overall age range was 31-67 years (52.0+9.3 years). The clinical evaluation included measurements of systolic (SBP) and diastolic blood pressure (DBP), heart rate, body weight and height as well as a medical examination. The patients were kept on placebo for 4 weeks, and the first plasma tHCY was assessed at baseline and followed by Irbesartan 150 mg or 300 mg daily for 12 weeks period. Then a second plasma tHCY determination was performed at the final visit (week 12). The fasting plasma tHCY levels were determined by the immunometric assay (Homocysteine IMMULITE Kit, Diagnostic Products Corporation, Los Angeles). The mean plasma tHCY level was reduced significantly after Irbesartan therapy (P<0.05). There was a significant difference in lowering both the SBP and DBP between the placebo and Irbesartan (P<0.05). Nevertheless, plasma tHCY levels did not correlate significantly with age, BMI, SBP and DBP.Our study shows that Irbesartan has beneficial metabolic effects on tHCY levels in hypertensive subjects after 3 months therapy. Irbesartan also demonstrates an excellent effect in blood pressure control. There were no correlations between tHCY with age, BMI, SBP and DBP noted.