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PubMed2001

Bezafibrate reduces heart rate and blood pressure in patients with hypertriglyceridemia.

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.

Absorption↗
PubMed2000

Hypertriglyceridemia and low high-density lipoprotein: risks for coronary artery disease?

Elevated total cholesterol and LDL cholesterol have been well established as risk factors for coronary heart disease (CHD). Several large clinical trials have demonstrated that lipid lowering decreases the incidence and mortality that results from CHD. However, a high percentage of subjects in these studies did not receive benefit from LDL lowering. Many experts believe that other lipid disorders may play a significant role in the atherogenic process, including elevated triglyceride levels alone or in association with a low level of HDL. Do elevated triglyceride levels pose an increased risk for CHD? This article describes the research done evaluating this question, as well as the influences of lifestyle changes and pharmacologic interventions on these dyslipidemias.

Cholesterol, HDL↗
PubMedDate not supplied

Hyperglycemia and hypertriglyceridemia in real world patients on antipsychotic therapy.

There have been recent reports in the psychiatric literature of the possible association of glucose dysregulation and diabetes mellitus with the use of atypical antipsychotics. This article describes a retrospective chart review of patients from various clinical settings, including a continuing day treatment program, two inpatient programs, and a large private practice. Information was obtained with regard to weight, fasting blood glucose, lipid profiles, EKG changes, and medical comorbidities. The patients included those treated with conventional antipsychotic agents, clozapine, risperidone, olanzapine, and quetiapine. No one antipsychotic agent was associated with a statistically significantly higher prevalence of diabetes, lipid abnormalities, or EKG problems. It was noted, however, that there were higher rates of diabetes (17%), lipid abnormalities (43%), and hypertension (30%) across the sample. This finding suggests that the high prevalence of diabetes, lipid abnormalities, and hypertension in a young, chronically psychiatrically ill population makes the case for aggressive screening.

Adult↗