Effect of Colchicine on Arterial Stiffness in Patients With Hypertension: The COlchicine HypERtENsion Trial (COHERENT)

AIM: This trial investigated whether colchicine, an anti-inflammatory treatment, affects cardiovascular structure and function, assessed by arterial stiffness, blood pressure and biochemistry, compared with placebo. METHODS: COHERENT was a randomized, double-blind, placebo-controlled trial of the effects of colchicine on arterial stiffness in adults with pharmacologically treated hypertension without cardiovascular disease. Eligible patients were randomized 1:1 to colchicine 0.5mg daily or placebo for six months. Assessment of arterial stiffness, echocardiography, and biomarker measurement were performed at baseline and six months. The primary endpoint was change in carotid-femoral pulse wave velocity (cfPWV). Secondary endpoints included change in blood pressure (BP), left ventricular mass index, as well as change in cardiac and inflammatory biomarkers. RESULTS: Of 183 screened, 150 were randomized (75 per group). Mean age was 64.5 (±8.0) years, 53 (35.3%) were female, and mean systolic blood pressure was 137.6 (±15.6) mmHg. At six months, cfPWV did not differ between groups (between-group difference in ΔcfPWV -0.1m/s, 95% CI: -0.5 to 0.3m/s, p=0.53). Office systolic BP decreased significantly more in the placebo group than in the colchicine group (between-group difference in Δoffice systolic BP 5.7 mmHg, 95% CI: 1.0 to 10.5 mmHg, p=0.018. hsCRP decreased significantly in the colchicine group compared with the placebo group (between-group difference in % change in hsCRP -39.8%, 95% CI: -59.1 to -11.4%, p=0.010). Left ventricular mass index or cardiac biomarkers did not differ between groups. CONCLUSIONS: Six months of colchicine did not affect arterial stiffness in pharmacologically treated hypertension without cardiovascular disease. Colchicine significantly decreased hsCRP.