Key result
Irbesartan improved arterial compliance in both elastic and muscular arteries, whereas lisinopril only improved elastic arteries (P<0.001 for difference in femoral dorsalis-pedis PWV).
Why the study?
Does irbesartan improve arterial compliance more than lisinopril in hypertensive patients?
RCT (n=15)
Double-blind
Randomized
Does irbesartan improve arterial compliance more than lisinopril in hypertensive patients?
Absolute Event Rate: 13.3% vs 14%
p-value: p=0.345
Irbesartan improves arterial compliance in both elastic and muscular arteries, whereas lisinopril only improves it in elastic arteries.
Irbesartan may be preferred over lisinopril for arterial compliance gains in hypertension; extends evidence of ARB vs ACEI vascular effects beyond BP lowering.
BACKGROUND: Antihypertensive agents can reduce arterial stiffness. We hypothesized that an angiotensin receptor blocker (ARB) irbesartan and an angiotensin converting enzyme inhibitor (ACEI) lisinopril improved arterial compliance. METHODS: A randomized, double-blind, double-dummy, controlled crossover trial. Fifteen hypertensive patients, mean age 65.5 +/- 8.9 years (mean +/- SD) were given irbesartan (150 to 300 mg/day) or lisinopril (10 to 20 mg/day) for 12 weeks and then crossed over for 12 weeks. Pulse wave velocity (PWV) in the carotid-femoral (CF), carotid-radial (CR), and femoral dorsalis-pedis (FD) were measured using a Complior((R)) PWV system. RESULTS: After 12 weeks, systolic blood pressure (SBP) decreased from 162.4 +/- 12.9 to 134.5 +/- 14.8 with irbesartan and to 145.2 +/- 25 mmHg with lisinopril. Irbesartan and lisinopril reduced PWV (CF) in the elastic arterial system from 15.1 +/- 5 to 13.3 +/- 2.6 (p < 0.005) and to 14 +/- 4.7 (p < 0.05) m/s respectively (p = 0.345). Irbesartan reduced PWV (CR) and PWV (FD), whereas lisinopril did not. The difference between treatments was significant after SBP adjustment (p = 0.037 for PWV (CR) and p < 0.001 for PWV (FD)). CONCLUSIONS: Irbesartan improved arterial compliance in elastic and muscular arteries, whereas lisinopril improved it only in elastic arteries.
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Khalid Ali (2009) conducted an RCT in Hypertension (n=15). Irbesartan vs. Lisinopril (10 to 20 mg/day) was evaluated on Pulse wave velocity (PWV) in the carotid-femoral (CF) artery (p=0.345). Irbesartan improved arterial compliance in both elastic and muscular arteries, whereas lisinopril only improved elastic arteries (P<0.001 for difference in femoral dorsalis-pedis PWV).
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