ACE inhibitors did not significantly reduce arterial stiffness compared to other antihypertensive drugs, but significantly lowered ba-PWV and cf-PWV levels when compared to placebo.
Meta-Analysis (n=1,458)
Do Angiotensin-Converting Enzyme Inhibitors (ACEIs) improve arterial stiffness compared to control in individuals including hypertensive patients?
ACE inhibitors reduce arterial stiffness compared to placebo, but do not show a significant difference when compared to other antihypertensive drugs.
To determine the effects of ACEIs on arterial stiffness, a meta-analysis of randomized controlled trials was conducted. Relevant articles that investigated the effects of ACEIs on arterial stiffness from PubMed, Embase, and the Cochrane library from inception to September 2018 were systematically retrieved. The investigated outcomes included brachial-ankle pulse wave velocity (ba-PWV) and carotid-femoral PWV (cf-PWV) by using weighted mean differences (WMDs) and 95% confidence intervals (CIs) with the random-effects model. A total of 17 RCTs including 1,458 individuals were included. The summary results indicated no significant differences between ACEIs and control for ba-PWV and cf-PWV. Also, no significant differences between ACEI and control for ba-PWV and cf-PWV were observed in hypertensive patients, while the therapeutic effects of ACEI versus placebo showed statistically significant difference. Moreover, subgroup analysis indicated that the levels of ba-PWV were significantly associated if the study was conducted in Western countries, mean age <60.0 years, percentage male ≥60.0%, compared with ARBs, baseline PWV <10.0, and high-quality study. Furthermore, the significant levels of cf-PWV in patients who received ACEIs were observed when percentage male was ≥60.0% and the studies were of high-quality. Finally, no significant differences were observed between ACEIs and other antihypertensive drugs regarding the changes of systolic blood pressure (SBP) and diastolic blood pressure (DBP). The overall analysis suggested no significant differences between ACEIs and other antihypertensive drugs for ba-PWV and cf-PWV levels, whereas ACEIs versus placebo showed lower levels of ba-PWV and cf-PWV.
Li et al. (Sun,) conducted a meta-analysis in Arterial stiffness (n=1,458). Angiotensin-Converting Enzyme Inhibitors (ACEIs) vs. Control (placebo or other antihypertensive drugs) was evaluated on Brachial-ankle pulse wave velocity (ba-PWV) and carotid-femoral PWV (cf-PWV). ACE inhibitors did not significantly reduce arterial stiffness compared to other antihypertensive drugs, but significantly lowered ba-PWV and cf-PWV levels when compared to placebo.