Do arterial stiffness and wave reflections improve more with angiotensin receptor blockers than with other antihypertensive drug classes?

In their meta-analysis Chen and co-authors pooled together ten randomized controlled studies assessing the effect of angiotensin II receptors blockers (ARBs) on pulse wave velocity (PWV) and augmentation index (AIx), compared to a mix of other antihypertensive drugs (1). The authors documented that ARB treatment was as effective as dihydropyridine calcium channel blockers, beta-blockers and diuretics on PWV, whereas the effect on AIx was superior with ARBs. Authors deliberately settled to limit their systematic review to hypertensive patients with no co-morbidities, in order to avoid any external bias on the evaluation of treatment efficacy. They also decided to include in the meta-analysis only studies with a sufficiently long-term follow-up, in order to increase the chance of observing a significant treatment effect.