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Continuous improvement of arterial compliance beyond blood pressure decrease after 5 years of antihypertensive
Claudio A Bellido1, Oscar R Iavicoli, Eduardo J Rusak
1Laboratory of Hypertension, Division of Cardiology, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina. claudiobellido@arnet.com.ar
Journal of Clinical Hypertension (Greenwich, Conn.)
|August 10, 2006
Summary
Antihypertensive drugs targeting the renin-angiotensin-aldosterone system significantly reduced pulse wave velocity, a marker of arterial stiffness, over 60 months in hypertensive patients.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biomedical Engineering
Background:
- Pulse wave velocity (PWV) is a key indicator of arterial compliance and stiffness.
- Increased arterial stiffness accelerates pulse wave propagation, impacting cardiovascular health.
- Evaluating arterial distensibility changes with antihypertensive therapies is crucial.
Purpose of the Study:
- To assess the impact of renin-angiotensin-aldosterone system (RAAS) inhibiting antihypertensive drugs on arterial distensibility.
- To monitor changes in pulse wave velocity (PWV) and blood pressure over a 60-month period.
- To investigate the relationship between RAAS blockade and arterial remodeling.
Main Methods:
- A 60-month prospective study involving 66 previously untreated hypertensive patients.
- Treatment with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs).
- Adjunctive therapies included diuretics, calcium channel blockers, or beta blockers as needed. Statistical analysis using ANOVA (alpha = 0.05).
Main Results:
- Systolic and diastolic blood pressure decreased significantly within the first year, with no further significant changes.
- No significant alterations in pulse pressure were observed.
- Pulse wave velocity (PWV) demonstrated a continuous and significant reduction throughout the 60-month follow-up (p < 0.0001).
Conclusions:
- RAAS-inhibiting antihypertensive medications effectively reduce arterial stiffness, as indicated by decreased PWV.
- The reduction in PWV was more pronounced than blood pressure changes after three years, suggesting arterial remodeling.
- Further research is warranted to elucidate the mechanisms linking RAAS blockade to improved arterial properties.
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