1. Changes in aortic pulse wave velocity in hypertensive postmenopausal women: comparison between a calcium channel blocker vs angiotensin receptor blocker regimen.
- Author
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Hayoz D, Zappe DH, Meyer MA, Baek I, Kandra A, Joly MP, Mazzolai L, Haesler E, and Periard D
- Subjects
- Aged, Amlodipine therapeutic use, Angiotensin II Type 1 Receptor Blockers therapeutic use, Blood Pressure drug effects, Calcium Channel Blockers therapeutic use, Double-Blind Method, Female, Humans, Male, Middle Aged, Postmenopause physiology, Tetrazoles therapeutic use, Valine pharmacology, Valine therapeutic use, Valsartan, Amlodipine pharmacology, Angiotensin II Type 1 Receptor Blockers pharmacology, Calcium Channel Blockers pharmacology, Hypertension diagnosis, Hypertension drug therapy, Pulse Wave Analysis, Tetrazoles pharmacology, Valine analogs & derivatives, Vascular Stiffness drug effects
- Abstract
Postmenopausal women are at greater risk for hypertension-related cardiovascular disease. Antihypertensive therapy may help alleviate arterial stiffness that represents a potential modifiable risk factor of hypertension. This randomized controlled study investigated the difference between an angiotensin receptor blocker and a calcium channel blocker in reducing arterial stiffness. Overall, 125 postmenopausal hypertensive women (age, 61.4 ± 6 years; systolic blood pressure/diastolic blood pressure [SBP/DBP], 158 ± 11/92 ± 9 mm Hg) were randomized to valsartan 320 mg ± hydrochlorothiazide (HCTZ) (n = 63) or amlodipine 10 mg ± HCTZ (n = 62). The primary outcome was carotid-to-femoral pulse wave velocity (PWV) changes after 38 weeks of treatment. Both treatments lowered peripheral blood pressure (BP) (-22.9/-10.9 mm Hg for valsartan and -25.2/-11.7 mm Hg for amlodipine, P = not significant) and central BP (-15.7/-7.6 mm Hg for valsartan and -19.2/-10.3 mm Hg for amlodipine, P<.05 for central DBP). Both treatments similarly reduced the carotid-femoral PWV (-1.9 vs -1.7 m/s; P = not significant). Amlodipine was associated with a higher incidence of peripheral edema compared with the valsartan group (77% vs 14%, P<.001). BP lowering in postmenopausal women led to a reduction in arterial stiffness as assessed by PWV measurement. Both regimens reduced PWV to a similar degree after 38 weeks of treatment despite differences in central BP lowering, suggesting that the effect of valsartan on PWV is mediated through nonhemodynamic effects., (© 2012 Wiley Periodicals, Inc.)
- Published
- 2012
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