The Xanthine Oxidase inhibitor Allopurinol improves endothelial function in different populations. Its effect on arterial stiffness parameters is less clear. We investigated the effect of short-term low-dose Allopurinol therapy on arterial stiffness parameters in stable Saudi patients with mild-moderate chronic heart failure.
Design and method:
A prospective, randomized, double-blind, placebo-controlled study was performed on 73 patients with mild-moderate chronic heart failure. 36 were randomized to Allopurinol 300 mg daily for 3 months, while 37 patients were randomized to placebo. Arterial stiffness parameters; augmentation index, aortic and brachial pulse wave velocity, were assessed at baseline and after 3 months. Serum uric acid concentration was measured at baseline and after 3 months.
66 patients completed the study. Both groups were matched for age and gender, and there was no difference in severity of heart failure between groups, 78% of all participants were NYHA class 2. Allopurinol recipients had a significant fall in their uric acid concentration from 6.31 ± 1.4 (SD) mg/dl to 3.81 ± 1.2, P < 0.001. Placebo group had no significant change in uric acid concentration. Comparing the change in uric acid between the two groups was significant with a mean drop of 2.44 ± 1.6 mg/dl in allopurinol group, vs −0.10 ± 0.9 in placebo group, P < 0.001. No significant difference in arterial stiffness parameters was observed between allopurinol and placebo groups. Heart rate corrected augmentation index in allopurinol group was 24.6 ± 9.6 % before treatment and 24.0 ± 9.1 after, P = 0.212. Aortic pulse wave velocity before treatment was 9.57 ± 2.7 m/s, and 9.85 ± 2.6 after, P = 0.563. Brachial pulse wave velocity before treatment was 9.33 ± 1.5 m/s, and 8.98 ± 1.1 after, P = 0.510.
We have shown that Allopurinol significantly reduced uric acid concentration in Saudi patients with chronic heart failure, yet it has not shown any significant improvement in their arterial stiffness parameters during the study period.