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Long-term anti-hypertensive therapy with benidipine improves arterial stiffness over blood pressure lowering
Toshihiro Kita1, Yoshihiko Suzuki, Tanenao Eto
1The First Department of Internal Medicine, Miyazaki Medical School, 5200 Kihara, Kiyotake, 889-1692, Miyazaki, Japan. t-kita@po.sphere.ne.jp
Insights
Long-term benidipine treatment improves arterial stiffness beyond blood pressure reduction. This study establishes a method to evaluate drug effects on arterial properties, showing benidipine benefits arterial wall health.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biomedical Engineering
Background:
- Pulse wave velocity (PWV) measures arterial stiffness, a predictor of cardiovascular events.
- Blood pressure (BP) influences PWV, complicating the assessment of anti-hypertensive drugs' effects on arterial properties.
- Benidipine is an anti-hypertensive drug whose specific effects on arterial wall properties require clarification.
Purpose of the Study:
- To establish a regression line between blood pressure (BP) and pulse wave velocity (PWV) changes.
- To evaluate the long-term effect of benidipine on arterial properties using the derived regression line.
- To determine if benidipine improves arterial wall properties independently of its BP-lowering effects.
Main Methods:
- A short-term experiment involved administering nicardipine intravenously to 29 participants to establish the BP-PWV relationship.
- A long-term study monitored BP and brachial-ankle PWV (baPWV) in 9 hypertensive patients treated with benidipine for 1 year.
- BP and baPWV were re-evaluated after a 2-week suspension of benidipine to assess sustained effects.
Main Results:
- The short-term experiment yielded a regression equation: deltaPWV (%) = 0.719 x deltaMBP (%), indicating PWV dependency on BP.
- In long-term therapy, benidipine achieved stable BP control within 3 months, with actual PWV decreases (r-PWV) matching estimated decreases (e-PWV).
- After 6 months, r-PWV exceeded e-PWV, suggesting benidipine improves arterial properties beyond BP reduction; these improvements persisted post-suspension.
Conclusions:
- Long-term benidipine administration enhances arterial wall properties independently of blood pressure reduction.
- The study provides a validated method to differentiate drug effects on BP versus direct arterial wall improvements.
- Benidipine demonstrates a sustained positive impact on arterial stiffness, offering potential benefits for cardiovascular health.
Abstract:
Pulse wave velocity (PWV) reflects arterial stiffness and is an independent predictor of cardiovascular mortality and morbidity. However, because it is closely related to blood pressure (BP), PWV is an imperfect measure for evaluating the effects of anti-hypertensive drugs on arterial wall properties. To clarify the effect of benidipine on arterial properties, we first derived the regression line between BP and PWV changes in a short-term experiment. Using this line, we evaluated the long-term effect of benidipine on PWV changes. In the short-term experiment, 29 participants were intravenously administered nicardipine for 90 min. Maximum decreases of brachial-ankle PWV (baPWV) were plotted against the corresponding decreases in BP. In the long-term experiment, 9 hypertensive patients were treated with benidipine for 1 year, during which BP and baPWV were monitored. After 1 year, benidipine was suspended for 2 weeks, and BP and baPWV were reevaluated. In the short-term experiment, PWV was dependent on BP only, and the equation of the regression line was deltaPWV (cm/s) =10.114 x deltaMBP (mmHg) (r=0.913) or deltaPWV (%) =0.719 x deltaMBP (%) (r=0.926). In the long-term therapy, benidipine treatment achieved stable BP control within 3 months; the real PWV decreases (r-PWV) were almost identical to the PWV decrease estimated (e-PWV) from BP lowering at 3 months. However, r-PWV exceeded e-PWV after 6 months. Relative BP and PWV improvements compared to the control were maintained 2 weeks after suspension of benidipine. In conclusion, long-term benidipine administration improves arterial wall properties beyond what can be accounted for by changes in BP.
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