Colchicine 0.5 mg daily for 6 months did not significantly reduce arterial stiffness compared with placebo in adults with hypertension (mean difference in cfPWV -0.1 m/s; 95% CI -0.5 to 0.3; p=0.53).
RCT (n=150)
Double-blind
1:1
Does colchicine reduce arterial stiffness in adults with pharmacologically well-controlled hypertension without known cardiovascular disease?
In adults with well-controlled hypertension without established cardiovascular disease, 6 months of low-dose colchicine significantly reduced inflammation (hsCRP) but did not improve arterial stiffness or blood pressure.
Mean Difference: -0.1 (95% CI -0.5–0.3)
p-value: p=0.53
Objective: Inflammation is part of the pathophysiology of hypertension. In this trial, we investigated whether anti-inflammatory treatment with colchicine would reduce arterial stiffness compared with placebo. Design and method: COHERENT was an investigator-initiated, randomized, double-blind, placebo-controlled trial of the effects of colchicine on arterial stiffness in adults with pharmacologically well-controlled hypertension without known cardiovascular disease. Eligible patients were randomized 1:1 to colchicine 0.5 mg daily or placebo. Assessment of arterial stiffness, echocardiography, and biochemistry was performed at baseline and after 6 months. The primary endpoint was the change in carotid-femoral pulse wave velocity (cfPWV). Secondary endpoints included blood pressure (BP), left ventricular mass index, and cardiac and inflammatory biomarkers. All endpoints were analyzed using linear mixed-effects models. Results: We screened 183 potential participants, of whom 150 were randomized (75 to colchicine and 75 to placebo) from August 2021 to July 2025. Mean age was 64.5 years (±8.0), 53 (35.3%) were female, mean systolic BP was 140.0mmHg (±16.5), and median hsCRP was 1.0 mg/L (0.5;2.1). At 6 months, no difference was found between the colchicine and placebo groups in change in cfPWV (between-group difference in δcfPWV -0.1m/s, 95%CI: -0.5 to 0.3m/s, p=0.53). Office-measured systolic BP decreased significantly more in the placebo group than in the colchicine group (between-group difference in δoffice-measured systolic BP 5.7mmHg, 95%CI: 1.0 to 10.5mmHg, p=0.018). hsCRP decreased significantly in the colchicine group compared with the placebo group (between-group difference in % change in hsCRP -39.8%, 95%CI: -59.1 to -11.4%, p=0.010). A prespecified subgroup analysis showed no differential effect of colchicine on cfPWV across the assessed subgroups. Low-dose colchicine was generally well-tolerated, and adverse events were primarily caused by gastrointestinal side effects and infections.Conclusions: In this population of adults with hypertension without other cardiovascular disease, 6 months of colchicine treatment did not significantly affect arterial stiffness. Colchicine significantly decreased hsCRP. The findings of this trial do not support a role for colchicine in improving vascular stiffness or blood pressure in patients with hypertension who do not have established cardiovascular disease.
Langhoff et al. (Fri,) conducted a rct in Hypertension (n=150). Colchicine vs. Placebo was evaluated on Change in carotid-femoral pulse wave velocity (cfPWV) (MD -0.1, 95% CI -0.5 to 0.3, p=0.53). Colchicine 0.5 mg daily for 6 months did not significantly reduce arterial stiffness compared with placebo in adults with hypertension (mean difference in cfPWV -0.1 m/s; 95% CI -0.5 to 0.3; p=0.53).