Reduction of age-associated arterial wall changes by low-dose valsartan

BACKGROUND: Functional and morphological arterial wall impairment progresses with ageing. Angiotensin II in the arterial wall is involved in this process. Appropriate early intervention might theoretically slow the progress of age-related changes. Herein, we investigated a new approach to this issue: whether arterial wall changes present in middle-aged males could be reduced by low-dose valsartan intervention. METHODS: Forty apparently healthy, middle-aged males (42.9 ± 0.9 years) were recruited for a double-blind randomized study and received either placebo or valsartan (20 mg daily) for 30 days. Brachial artery flow-mediated dilation (FMD), pulse wave velocity (PWV), and β-stiffness of the common carotid artery were measured using an Aloka alfa-10 Prosound with an integrated eTracking system at inclusion, after 30 days, and after 3 and 8 months. RESULTS: Intervention resulted in FMD increase (154.2 ± 20.1 %; p < 0.001) and PWV and β-stiffness decrease compared to initial values (-6.9 ± 1.0 % and -13.2 ± 1.4 %; both p < 0.01) whereas values in the untreated group (p < 0.001 for all parameters) remained unchanged throughout the study. The advantageous effects decreased over the months following valsartan discontinuation, but were still significant after 3 months (largely in FMD and less in PWV and β-stiffness), and negligible after 8 months. The beneficial effects were ascribed to valsartan's pleiotropic effects, as no blood pressure changes were recorded. CONCLUSIONS: We showed that age-related arterial wall changes in middle-aged males are reversible and could be reduced by a low-dose, short-term valsartan intervention. The new approach merits detailed investigation in future studies.