Valsartan and retinal endothelial function in elderly hypertensive patients

BACKGROUND: The aim of this study was to investigate the impact of short-term treatment with the angiotensin II receptor blocker (ARB) valsartan on retinal endothelial function in elderly patients with mild to moderate essential hypertension. METHODS: In an open-labeled study, 20 elderly, male patients with arterial hypertension (WHO I-II) were treated with the ARB valsartan (80-160 mg once daily) over 8 days. Central retinal artery perfusion at rest and during flicker light stimulation was measured before and after treatment using pulsed wave Doppler sonography. Retinal capillary flow was assessed with scanning laser Doppler flowmetry at rest and following systemic infusion of the nitric oxide synthase (NOS) inhibitor NG-monomethyl-L-arginine (L-NMMA). RESULTS: While valsartan significantly lowered blood pressure, central retinal artery perfusion at rest as well as after flicker light stimulation was similar before and after treatment. Similarly, retinal capillary flow at rest and after infusion of L-NMMA did not change with valsartan after 7 days of treatment. Subgroup analysis revealed that changes in retinal capillary flow in response to L-NMMA might be dependent on serum low-density lipoprotein (LDL) cholesterol levels of study participants. After treatment with valsartan, retinal capillary flow in response to L-NMMA decreased more in patients with low (< 3.54 mmol/l) than with high LDL-cholesterol levels (-12.6 +/- 20.2% vs 12.3 +/- 19.5%, p < 0.05). CONCLUSION: Short-term treatment with valsartan did not improve retinal endothelial function in elderly hypertensive patients.