Key Points
- To evaluate whether improvements in arterial compliance depend entirely on blood pressure reduction or vary among distinct antihypertensive drug classes.
- Evaluated 39 subjects with essential hypertension treated to normotensive values with dihydropyridine calcium channel antagonists (CaBl, n = 11), converting enzyme inhibitors (CEI, n = 9), angiotensin receptor blockers (ARB, n = 9), or beta-blockers (BBl, n = 10).
- Measured capacitive (C1) and oscillatory (C2) arterial compliance using computerized arterial pulse waveform analysis at baseline, 1 month, and 3 months post-treatment.
- All four drug classes produced equivalent blood pressure reductions: CaBl (-19 +/- 4/-15 +/- 2 mm Hg), CEI (-12 +/- 3/-13 +/- 2 mm Hg), ARB (-10 +/- 3/-12 +/- 2 mm Hg), and BBl (-14 +/- 3/-12 +/- 2 mm Hg; P < .005 for each vs pretreatment).
- CaBl, CEI, and ARB significantly enhanced arterial compliance from baseline: CaBl (%deltaC1 = 30.0 +/- 5.8, %deltaC2 = 43.7 +/- 23.3), CEI (%deltaC1 = 32.7 +/- 5.4, %deltaC2 = 26.7 +/- 7.1), and ARB (%deltaC1 = 36.3 +/- 11.8, %deltaC2 = 43.6 +/- 23.1; P < .01 for all vs pretreatment).
- Beta-blockers did not significantly alter compliance (%deltaC1 = -3.9 +/- 7.6, %deltaC2 = -7.0 +/- 11.5; P = not significant vs pretreatment; P = 0.01 vs the other three drug classes).
Structured PICO
Do different classes of antihypertensive drugs have differential effects on arterial compliance in subjects with essential hypertension despite equivalent blood pressure reduction?
PPopulation39 subjects with essential hypertension
IInterventionAntihypertensive therapy with dihydropyridine calcium channel antagonists (n=11), converting enzyme inhibitors (n=9), angiotensin receptor blockers (n=9), or beta-blockers (n=10) administered to achieve normotensive blood pressure values
CComparatorPretreatment baseline and between-drug class comparisons
OOutcomeCapacitive (C1) and oscillatory (C2) components of arterial compliance measured by computerized arterial pulse waveform analysis (CAPWA) at 1 and 3 monthssurrogate
For an equivalent reduction in blood pressure, calcium channel blockers, ACE inhibitors, and ARBs improve arterial compliance, whereas beta-blockers do not.