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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
09:33

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology

Published on: February 7, 2015

Carotid intima-media thickness and antihypertensive treatment: a meta-analysis of randomized controlled trials

Ji-Guang Wang1, Jan A Staessen, Yan Li

  • 1Studies Coordinating Centre, Hypertension and Cardiovascular Rehabilitation Unit, Department of Cardiovascular Diseases, University of Leuven, Belgium. jiguangwang@netscape.net

Stroke
|June 10, 2006
PubMed

Insights

Calcium-channel blockers (CCBs) and other antihypertensives reduce carotid intima-media thickening. CCBs show particular benefit, potentially reducing stroke risk.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Hypertension is a known risk factor for carotid intima-media thickening.
  • Carotid intima-media thickness is a marker of atherosclerosis and cardiovascular risk.

Purpose of the Study:

  • To evaluate the effects of antihypertensive drugs on carotid intima-media thickness.
  • To compare the efficacy of different classes of antihypertensive agents in reducing carotid intima-media thickening.

Main Methods:

  • Systematic review and meta-analysis of 22 randomized controlled trials.
  • Searched PubMed and Web of Science databases for trials published before 2005.
  • Included trials comparing antihypertensive drugs versus placebo or different drug classes.

Main Results:

  • Antihypertensive treatment with ACE inhibitors, beta-blockers, or CCBs reduced intima-media thickening by 7 microm/year compared to placebo (P=0.01).
  • Newer agents (CCBs, ACE inhibitors, ARBs, alpha-blockers) decreased intima-media thickening by 3 microm/year versus older agents (diuretics, beta-blockers) (P=0.03).
  • CCBs demonstrated a significant reduction in intima-media thickening (5 microm/year, P=0.007) and attenuated thickening by 23 microm/year compared to ACE inhibitors (P=0.02).

Conclusions:

  • Calcium-channel blockers (CCBs) effectively reduce carotid intima-media thickening.
  • This reduction in carotid intima-media thickness may contribute to the stroke-protective benefits of CCBs.
Abstract

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