Effects of Selective Angiotensin II Type 1 Receptor Blockade with Losartan on Arterial Compliance in Patients with Mild Essential Hypertension

It has been suggested that antihypertensive drugs should not only decrease blood pressure, but also improve large artery compliance. The aim of the present study was to examine the effect of losartan, a selective angiotensin II type 1 receptor antagonist, on parameters reflecting arterial compliance. In a randomized, double-blind cross-over study, 16 patients with mild essential hypertension were examined after 4 weeks of treatment with placebo/losartan. The effect on finger plethysmographic arterial pulse curves were quantified by computing the relative height of the dicrotic notch, and pulse wave velocity was estimated by measurements of the time delay from the start of the QRS-complex (electrocardiogram) to the foot of the plethysmographic pulse wave. Compared with placebo, losartan reduced the relative height of the dicrotic notch from 55% (SD 12) to 47% 14 (p < 0.01), and pulse wave velocity from 9.3 m/sec to 8.7 m/sec (p < 0.05). The supine blood pressure decreased from 146/89 mmHg to 134/82 mmHg (p < 0.01). There was no correlation between the effects on blood pressure and the effects on the arterial compliance parameters, suggesting that losartan exerted an effect on arterial compliance beyond its effect on blood pressure.