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Changes in arterial structure and function under trandolapril-verapamil combination in hypertension
J Topouchian1, R Asmar, F Sayegh
1Department of Internal Medicine, Broussais Hospital, Paris, France.
Stroke
|May 7, 1999
Summary
Hypertension treatments including ACE inhibitors and calcium channel blockers affect large arteries. Site-specific arterial changes were observed, with combination therapy showing greater blood pressure reduction and improved arterial distensibility.
Area of Science:
- Cardiovascular medicine
- Pharmacology
- Hypertension research
Background:
- Angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers impact large arteries in hypertension.
- Previous research has not investigated the site-specific heterogeneity of these arterial responses.
Purpose of the Study:
- To investigate the impact of verapamil, trandolapril, and their combination on large arteries at different measurement sites.
- To analyze the heterogeneity of cardiovascular responses based on arterial site.
Main Methods:
- A 180-day double-blind study comparing verapamil, trandolapril, and combination therapy in hypertensive patients.
- Utilized echo-Doppler and applanation tonometry to measure pressure, diameter, and distensibility at brachial, carotid, and aortic sites.
- Assessed cardiac and carotid wall structure changes.
Main Results:
- Combination therapy yielded greater reductions in mean and pulse pressures.
- Significant increases in arterial distensibility were observed across multiple sites (carotid, aorta, brachial).
- Reduced abdominal aorta and carotid artery diameter; cardiac mass regression was more pronounced than carotid wall thickening.
Conclusions:
- Both ACE inhibitors and calcium channel blockers, especially in combination, effectively lower blood pressure.
- Arterial diameter, thickness, and stiffness modifications are site-dependent.
- Muscular arteries showed increased distensibility, while cardiac hypertrophy regressed significantly.