Related Experiment Videos
Vascular complications in hypertension: the VHAS study. Verapamil-Hypertension Atherosclerosis Study
1Istituto di Clinica Medica Generale e Terapia Medica, Universita di Milano, Italy.
Insights
The Verapamil-Hypertension Atherosclerosis Study found that two-thirds of hypertensive patients without prior cardiovascular events had asymptomatic carotid artery alterations. This highlights the prevalence of subclinical atherosclerosis in this population.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Atherosclerosis Imaging
Background:
- Essential hypertension is a major risk factor for cardiovascular disease.
- Subclinical atherosclerosis may be present in hypertensive patients even without prior cardiovascular events.
- Early detection of atherosclerosis is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the prevalence of asymptomatic carotid alterations in middle-aged hypertensive patients.
- To evaluate the development of atherosclerosis using ultrasound imaging in a hypertensive cohort.
- To assess the impact of antihypertensive therapies on atherosclerosis progression.
Main Methods:
- The Verapamil-Hypertension Atherosclerosis Study (VHAS) enrolled 1464 patients with essential hypertension.
- Patients received either slow-release verapamil or chlorthalidone for 2 years, with captopril added for non-responders.
- A subgroup of 494 patients underwent extended follow-up (4 years) with beta-mode ultrasound to detect atherosclerosis.
Main Results:
- Approximately two-thirds of the studied hypertensive patients exhibited asymptomatic carotid alterations.
- This finding was observed in middle-aged individuals without a history of previous cardiovascular events.
- The study is ongoing, with atherosclerosis development as the primary endpoint.
Conclusions:
- A significant proportion of hypertensive patients, even without prior cardiovascular events, have subclinical atherosclerosis.
- Ultrasound imaging can detect early signs of atherosclerosis in this population.
- Further research is needed to understand the long-term implications and therapeutic targets.
Abstract:
The VHAS (Verapamil-Hypertension Atherosclerosis Study) Investigators entered 1464 patients with essential hypertension and blood pressure (BP) values > or = 160 mmHg systolic and 95 mmHg diastolic (DBP) but excluded those with a DBP > or = 115 mmHg, and those with diabetes mellitus or previous myocardial infarction or cerebrovascular episodes. Patients were randomly allocated to drug therapy for 2 years with either slow-release verapamil 240 mg once daily or chlorthalidone 25 mg once daily, with nonresponders receiving additional captopril 25 mg daily. A random group of eligible patients (n = 494) was followed for a more extended period (4 years) using beta-mode ultrasound. The end point is the development of atherosclerosis detected by ultrasound imaging. The most interesting observation thus far is that in this population of middle-aged hypertensives without a history of previous cardiovascular events, about two thirds had asymptomatic carotid alterations. The study is ongoing.