Key result
Candesartan monotherapy is linked to a ~5% HDL-C decrease, driven by female subjects.
Why the study?
Does candesartan monotherapy alter plasma lipid profiles in patients with mild to moderate hypertension?
Observational (n=483)
Yes
Does candesartan monotherapy alter plasma lipid profiles in patients with mild to moderate hypertension?
Absolute Event Rate: 1.4% vs 1.47%
p-value: p=0.0218
Candesartan monotherapy in patients with mild to moderate hypertension has a minimal effect on lipid metabolism, with only a slight decrease in HDL-C observed in females.
Candesartan shows minimal lipid effects in hypertension; leaves open possible sex-specific HDL reduction and needs randomized confirmation.
BACKGROUND: Studies 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. METHODS: We 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. RESULTS: Plasma 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 approximately 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 approximately 9 months period: p = 0.0054), but not in male subjects. CONCLUSIONS: Our 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.
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Nishida et al. (2010) conducted an observational in Hypertension (n=483). Candesartan cilexetil vs. Baseline (pre-treatment) was evaluated on Plasma HDL-C level at 6 to 9 months (nmol/L) (p=0.0218). Candesartan monotherapy slightly decreased HDL-C levels at 6 to 9 months compared to baseline (1.40 vs 1.47 nmol/L), an effect driven by female subjects, with no significant changes in TG, TC, or LDL-C.
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