Document Detail

Bezafibrate reduces heart rate and blood pressure in patients with hypertriglyceridemia.
MedLine Citation:
PMID:  11330878     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In hypertriglyceridemic patients, hypertension occurs frequently and may be associated with hyperinsulinemia and elevated plasma levels of free fatty acids (FFA). Besides the lipid-lowering effects, fibrates have been shown to reduce blood pressure in hypertensive patients. The present study was undertaken to investigate the effects of bezafibrate on hemodynamics in relation to insulin, FFA, sympathetic activity, renal sodium absorption, cyclic-GMP (cGMP) and endothelin-1 in hypertriglyceridemic patients. SUBJECTS AND METHODS: Hypertriglyceridemic patients (17) were randomized to receive in a double-blind placebo-controlled study bezafibrate or placebo for 6 weeks. At the end of both treatment periods, blood pressure and heart rate were measured automatically. Plasma insulin, FFA, aldosterone, catecholamines, cGMP, endothelin-1 levels and 24 h urine catecholamines and sodium excretion were assessed. RESULTS: Bezafibrate therapy decreased serum triglycerides (-65%, P < 0.001) and hemodynamic parameters: heart rate decreased from 69 to 66/min (P = 0.009), systolic blood pressure from 137 to 132 mmHg (P = 0.01), diastolic blood pressure from 81 to 79 mmHg (P = 0.07) and mean blood pressure from 102 to 99 mmHg (P = 0.06). Bezafibrate therapy reduced FFA and insulin (-55 and -57% respectively, both P < 0.001), while sympathetic activity and renal sodium absorption were not affected. cGMP increased (+17%, P = 0.008), whereas endothelin-1 levels tended to decrease upon bezafibrate therapy (-10%, P = 0.077) CONCLUSION: Bezafibrate reduces heart rate, blood pressure, insulin and FFA in hypertriglyceridemic patients. The hemodynamic effects cannot be attributed to changes in sympathetic activity or renal sodium absorption. Instead, based on the increase in plasma cGMP levels, the bezafibrate-induced hemodynamic effects are most likely to be caused by bezafibrate-induced improvement of endothelial function.
I J Jonkers; F H de Man; A van der Laarse; M Frölich; J A Gevers Leuven; A M Kamper; G J Blauw; A H Smelt
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  19     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-05-01     Completed Date:  2001-08-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  749-55     Citation Subset:  IM    
Department of General Internal Medicine, Leiden University Medical Center, The Netherlands.
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MeSH Terms
Antilipemic Agents / therapeutic use*
Bezafibrate / therapeutic use*
Blood Pressure / drug effects*
Cyclic GMP / blood
Double-Blind Method
Fatty Acids, Nonesterified / blood
Heart Rate / drug effects*
Hemodynamics / drug effects
Hypertriglyceridemia / drug therapy*,  physiopathology*
Insulin / blood
Kidney / metabolism
Lipids / blood
Middle Aged
Sodium / metabolism
Sympathetic Nervous System / physiopathology
Reg. No./Substance:
0/Antilipemic Agents; 0/Fatty Acids, Nonesterified; 0/Lipids; 11061-68-0/Insulin; 41859-67-0/Bezafibrate; 7440-23-5/Sodium; 7665-99-8/Cyclic GMP
Comment In:
J Hypertens. 2001 Apr;19(4):675-7   [PMID:  11330868 ]

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