Carotid Intima-Media Thickness and Antihypertensive Treatment
Key result
Antihypertensive treatment reduced carotid intima-media thickening by 7 microm/year versus placebo (P=0.01), and calcium-channel blockers decreased thickening by 5 microm/year versus older drugs (P=0.007).
Why the study?
Does antihypertensive treatment reduce the rate of carotid intima-media thickening compared to placebo or older antihypertensive classes in patients with hypertension, diabetes, or coronary heart disease?
Population
Patients with hypertension, diabetes, or coronary heart disease (22 randomized clinical trials)
Comparison
Antihypertensive treatment vs Placebo, no treatment, or older antihypertensive…
Design
Meta-analysis
Authors
Discussion
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Implication
Favors CCBs and newer antihypertensives to slow carotid thickening; extends class effects beyond blood pressure reduction.
Key Points
- Assess the impact of various antihypertensive drugs on carotid intima-media thickness in patients with hypertension or related conditions.
- Included 22 randomized controlled trials published before 2005
- Analyzed trials comparing antihypertensive treatments with placebo or other drug classes
- Evaluated effects on carotid intima-media thickness in diverse hypertensive populations
- Angiotensin-converting enzyme inhibitors, beta-blockers, or calcium-channel blockers reduced intima-media thickening by 7 microm/year (P=0.01)
- Calcium-channel blockers and other newer agents decreased thickening by 3 microm/year (P=0.03) compared to diuretics
- Calcium-channel blockers specifically lowered thickening by 23 microm/year (P=0.02) compared to ACE inhibitors
Study Design
Type
Systematic Review
Structured PICO
Does antihypertensive treatment reduce the rate of carotid intima-media thickening compared to placebo or older antihypertensive classes in patients with hypertension, diabetes, or coronary heart disease?
P
Population
Systematic review of 22 randomized clinical trials evaluating the effects of antihypertensive drugs versus placebo or other classes on carotid intima-media thickness.
I
Intervention
Antihypertensive treatment (including ACE inhibitors, beta-blockers, calcium-channel blockers, angiotensin II receptor blockers, or alpha-blockers)
C
Comparator
Placebo, no treatment, or older antihypertensive drugs (diuretics or beta-blockers)
O
Outcome
Rate of carotid intima-media thickeningsurrogate
Main Result
Mean Difference: -7
p-value: p=0.01
Calcium-channel blockers and other newer antihypertensive agents significantly reduce carotid intima-media thickening compared to older drugs or placebo, an effect that correlates with lumen diameter changes but not with the degree of blood pressure reduction.
Cite This Study
Wang et al. (2006) conducted a systematic review in Hypertension, diabetes, or coronary heart disease. Antihypertensive treatment (including CCBs, ACE inhibitors, ARBs, alpha-blockers) vs. Placebo, no treatment, diuretics, or beta-blockers was evaluated on Rate of carotid intima-media thickening (7 microm/year reduction, p=0.01). Antihypertensive treatment reduced carotid intima-media thickening by 7 microm/year versus placebo (P=0.01), and calcium-channel blockers decreased thickening by 5 microm/year versus older drugs (P=0.007).