Differential effects of antihypertensive drug therapy on arterial compliance

Although the abnormal vascular compliance, ΔV/ΔP, characteristic of essential hypertension can be improved by antihypertensive drug therapy, it is not clear whether these changes a) can be attributable solely to lower achieved BP and pulse pressure values, and therefore b) are equally likely with different drugs possessing similar antihypertensive efficacy. We therefore used computerized arterial pulse waveform analysis (CAPWA) of the radial artery to measure capacitative (C1) and oscillatory (C2) components of arterial compliance in essential hypertensive subjects (n = 39) before and three months after administration of dihydropyridine calcium channel antagonists (CaBl), converting enzyme inhibitors (CEI), angiotensin receptor blockers (ARB), and beta-blockers (Bbl). Results showed: (See Table) p < 0.005 vs initial BP, C1, or C2, sig = 0.01 vs other drug despite equivalent effects on BP, CaBl, CEI, and ARB, but not Bbl significantly improved arterial compliance. p < 0.005 vs initial BP, C1, or C2, sig = 0.01 vs other drug despite equivalent effects on BP, CaBl, CEI, and ARB, but not Bbl significantly improved arterial compliance. We conclude that for the same effect on BP: i) arterial compliance improves following therapy with some, but not all antihypertensive drugs, and ii), greater clinical benefit may result from the preferential use of drugs that concomitantly improve arterial compliance.