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Published on: September 17, 2015

Differential effects of antihypertensive drug therapy on arterial compliance

Lawrence M Resnick1, Melvin H Lester

  • 1Hypertension Center, New York Presbyterian Hospital-Cornell University Medical Center, New York, New York 10021, USA. lmresnick@aol.com

American Journal of Hypertension
|December 4, 2002
PubMed

Insights

Antihypertensive drugs differentially improve vascular compliance, independent of blood pressure reduction. Some medications, like calcium channel blockers, angiotensin receptor blockers, and ACE inhibitors, enhance arterial compliance, while beta-blockers do not.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Hypertension Research

Background:

  • Vascular compliance is abnormal in essential hypertension and can be improved by antihypertensive therapy.
  • It remains unclear if drug-induced changes in vascular compliance are solely due to reduced blood pressure or if specific drug classes have differential effects.

Purpose of the Study:

  • To investigate whether different classes of antihypertensive drugs, despite similar blood pressure-lowering efficacy, differentially affect arterial compliance.
  • To determine if improvements in arterial compliance are drug-class specific or solely a consequence of blood pressure reduction.

Main Methods:

  • Computerized arterial pulse waveform analysis (CAPWA) was used to measure capacitive (C1) and oscillatory (C2) components of arterial compliance.
  • 39 essential hypertensive subjects were studied before and after 1-3 months of treatment with dihydropyridine calcium channel antagonists (CaBl), converting enzyme inhibitors (CEI), angiotensin receptor blockers (ARB), or beta-blockers (BBl) to achieve normotensive blood pressure.

Main Results:

  • All drug classes achieved equivalent reductions in blood pressure.
  • CaBl, CEI, and ARB significantly increased both capacitive (C1) and oscillatory (C2) components of arterial compliance.
  • Beta-blockers (BBl) did not significantly alter arterial compliance compared to baseline, despite equivalent blood pressure reduction.

Conclusions:

  • Arterial compliance improves with antihypertensive therapy in a drug-class-dependent manner, beyond the effects of blood pressure reduction.
  • Drugs such as CaBl, CEI, and ARB enhance arterial compliance, whereas BBl do not.
  • Preferential use of antihypertensive drugs that also improve arterial compliance may lead to greater clinical benefit in managing hypertension.

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