O-38: Effect of delapril and irbesartan on plasma PAI-1 and fibrinogen in hypertensive type 2 diabetic patients

The aim of this study was to compare the effect of Delapril and Irbesartan on PAI-1 and Fibrinogen in hypertensive type 2 diabetic patients, a population with a known impaired fibrinolysis. We studied 80 mild to moderate hypertensive patients (DBP>90 and ≤100 mmHg) with well controlled NIDDM, aged 45 to 65 years. Smoker patients were excluded. After a 4 week wash-out placebo period patients were randomly assigned to receive Delapril 30 mg o.d. (n=40) or Irbesartan 150 mg o.d. (n=40) for 12 weeks according to a randomized parallel group design. At the end of the placebo period and of the active treatment period blood pressure was measured and blood samples were taken to evaluate plasma PAI-1, fibrinogen, glucose, HbA1c, cholesterol and triglycerides. The main results are as follows: No treatment significantly influenced blood glucose, HcA1c and lipid values. These results show that Delapril decreases PAI-1 levels in hypertensive type 2 diabetic patients, while Irbesartan increases it. It suggests that this effect is unrelated with AT-1 receptor blockade: it could be due to the fact that the endothelial receptors that mediate PAI-1 expression in response to Angiotensin II are not type 1 receptor subtypes. (See Table) Placebo Delapril Placebo Irbesartan SBP 154 ± 12 139 ± 10** 153 ± 13 140 ± 11** DBP 95 ± 4 83 ± 6** 96 ± 4 85 ± 7** PAI-1 (ng/ml) 39 ± 19 29 ± 15* 37 ± 18 48 ± 17*,° Fibrinogen(mg/dl) 338 ± 66 322 ± 59 331 ± 67 342 ± 65 *p < 0,05 **p < 0,01 vs placebo °p < 0,05 vs Delapril