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Verapamil and nebivolol improve carotid artery distensibility in hypertensive patients
T van Merode1, L M van Bortel, F A Smeets
1Department of Physiology, University of Limburg, Maastricht, The Netherlands.
Insights
Verapamil and nebivolol improve carotid artery distensibility and compliance in hypertensive patients. These blood pressure medications may help protect against atherosclerotic complications.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biomedical Engineering
Background:
- Hypertension is associated with arterial stiffening, increasing cardiovascular risk.
- Verapamil (calcium antagonist) and nebivolol (beta-blocker) are used to manage hypertension.
- Assessing arterial distensibility and compliance is crucial for cardiovascular risk stratification.
Purpose of the Study:
- To evaluate the effects of verapamil and nebivolol on carotid artery distensibility and cross-sectional compliance in hypertensive patients.
- To compare the non-invasive assessment of arterial properties with these antihypertensive agents.
Main Methods:
- A high-resolution multigate pulsed Doppler system was used for non-invasive assessment of carotid artery distensibility and compliance.
- Patients with essential hypertension underwent a double-blind, placebo-controlled crossover study.
- Treatments included verapamil (120 mg TID) or nebivolol (5 mg QD) for 4 weeks, compared to placebo.
Main Results:
- Both verapamil and nebivolol significantly increased carotid artery distensibility and cross-sectional compliance compared to placebo (P < 0.05).
- No significant differences in carotid artery diameter or pulse pressure were observed between drug and placebo groups.
- Both verapamil and nebivolol demonstrated similar reductions in blood pressure.
Conclusions:
- Verapamil and nebivolol favorably influence carotid artery distensibility and compliance in hypertensive individuals.
- Improved arterial properties may contribute to better systolic pressure pulse management.
- Enhanced carotid artery distensibility may offer protection against hypertension-related atherosclerotic complications.
Abstract:
The effects of verapamil (a calcium antagonist) and nebivolol (a novel, selective beta 1-adrenoceptor blocker) on carotid artery distensibility and cross-sectional compliance were studied non-invasively in hypertensive patients with the use of a high-resolution multigate pulsed Doppler system. Arm blood pressure measurements were made with an automated device (Dinamap). After a 4-week washout period, 19 patients (aged 21-73 years) with essential hypertension entered a double-blind randomized placebo-controlled crossover study with 120 mg verapamil or placebo three times a day for 4 weeks. After the administration of verapamil, carotid artery distensibility and cross-sectional compliance were significantly larger (P less than 0.05) than after placebo. Using the same protocol, 29 patients (aged 25-70 years) were given 5 mg nebivolol or placebo once a day for 4 weeks. After the administration of nebivolol, carotid artery distensibility and cross-sectional compliance were significantly larger (P less than 0.05) than after placebo. In both studies no significant differences in diameter and pulse pressure were found between placebo and verapamil or nebivolol. Blood pressure was decreased similarly with both verapamil and nebivolol. These results indicate that both verapamil and nebivolol favourably influence carotid artery distensibility and cross-sectional compliance of the common carotid artery, resulting in a better management of the systolic pressure pulse. The improved carotid artery distensibility may help to protect the patient against atherosclerotic complications of hypertension.