Key result
Antihypertensive monotherapy reduces PWV and improves carotid shear stress equally across five tested drugs.
Why the study?
The comparative effects of different antihypertensive drugs on arterial stiffness, shear stress, and metalloproteinase activity in untreated hypertensive patients were unclear.
Does antihypertensive monotherapy improve arterial stiffness, shear stress, and metalloproteinase activity in treatment-naive patients with stage 1 or 2 hypertension?
RCT (n=95)
randomized
Does antihypertensive monotherapy improve arterial stiffness, shear stress, and metalloproteinase activity in treatment-naive patients with stage 1 or 2 hypertension?
Antihypertensive therapy reduces arterial stiffness and alters connective tissue metabolism similarly across different drug classes.
Answers are grounded in this paper and cite their sources.
Supports monotherapy in early hypertension to improve vascular markers; confirms class-independent effects on stiffness and matrix remodeling in RCT.
Objective: Comparison of therapeuthic effects of chosen antihypertensive drugs on arterial stiffness, shear stress in carotid arteries and metalloproteinases activity, moreover analysis of relationship of these variables in the course of treatment. Design and method: 95 never treated patients with HT stage 1 or 2 were randomized to 6 months monotherapy with: quinapril, amlodipine, hydrochlorothiazide, losartan or bisoprolol. Each therapeuthic group consisted of 19 patients (N=19). Before and then after 1, 3 and 6 months of treatment carotid-femoral pulse wave velocity (PWV) by using a Complior device, ultrasound of carotid arteries were performed. Blood samples for the measurement of whole blood viscosity were taken during each visit. Shear stress (SS) was calculated on the basis of Irace formula. Serum concentration of metalloproteinase 3 (MMP-3) and plasma concentration of tissue inhibitor of metalloproteinase 1 (TIMP-1) were measured at the initial visit and after 6 months of treatment. Results: ANOVA for repeated measurements revealed for all groups significant decrease of PWV and MMP-3 concentration and increase of shear stress in carotid artery and TIMP-1 concentration (p<0.05). No between groups differences appeared in above effects (p>0.05). Conclusion: Irrespectively of chosen drug we observed similar effect for PWV drop. Reduction of arterial stiffness as a result of antihypertensive therapy is strongly connected with shear stress increase that is secondary to blood flow velocity growth and changes in connective tissue metabolism.
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Pizon et al. (2015) conducted an RCT in Hypertension stage 1 or 2 (n=95). Antihypertensive monotherapy (quinapril, amlodipine, hydrochlorothiazide, losartan, or bisoprolol) vs. Active comparators (between-group comparison) was evaluated on Change in carotid-femoral pulse wave velocity (PWV), MMP-3, shear stress, and TIMP-1 (p=<0.05). Antihypertensive monotherapy decreased pulse wave velocity and MMP-3 concentration, and increased carotid shear stress and TIMP-1 concentration, with no significant differences between the five tested drugs.
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