P3.1 Beneficial Effects of Hypertriglyceridemia Treatment on Microvascular Endothelial Function in Treated Hypertensive Patients

Abstract

Background

The relationship between increased levels of triglycerides (TG) and cardiovascular (CV) risk is controversial, and the effects on endothelial function are also unclear.

Objective

To investigate the effects of hypertriglyceridemia treatment on vascular function in treated hypertensive patients.

Methods

Thirty-six hypertensive patients with TG levels 150 to 499 mg/dl, both genders, aged 40–65 years, were randomized to receive active treatment (fish oil or fibrate) or placebo for 3 months. Systolic and diastolic blood pressure (SBP and DBP), brachial flow-mediated dilation (FMD), reactive hyperemia index (RHI) by peripheral artery tonometry, pulse wave velocity (PWV), carotid intima-media thickness (IMT) and central hemodynamic parameters were determined at baseline and after 3-month intervention.

Results

Treatment group presented significant decrease in SBP (139±17 to 134±12mmHg, p<0.05), DBP (86±11 to 81±9mmHg, p<0.05), TG levels (255±73 to 156±77mg/dl, p<0.001), carotid-radial PWV (10.9±1.8 to 10.2±1.2m/s, p<0.05) and aortic SBP (131 ±16 to 125±10mmHg, p<0.05) compared with control group. Treatment group showed significantly improvement in RHI (1.87±0.36 to 2.13±0.49 units, p<0.05). No significant effect was observed on FMD and carotid IMT. RHI increase was correlated with TG reduction (r=−0.40, p = 0.043) and baseline TG/HDL (r=0.44, p = 0.023), RHI (r=0.40, p = 0.041) and aortic pulse pressure (r=0.45, p = 0.020). After multiple linear regression, RHI improvement was only associated to TG decrease (B = −0.001, p = 0.043) and baseline aortic pulse pressure (B = −0.012, p = 0.023).

Conclusion

The treatment of hypertriglyceridemia was associated with improvement in microvascular endothelial function in treated hypertensive patients suggesting that TG levels reduction may have vascular protective effects in these patients.