Colchicine 0.5 mg daily for 6 months did not significantly reduce arterial stiffness compared with placebo in adults with hypertension (mean difference in cfPWV -0.1 m/s; 95% CI -0.5 to 0.3; p=0.53).
RCT (n=150)
Double-blind
1:1
Does colchicine reduce arterial stiffness in adults with pharmacologically well-controlled hypertension without known cardiovascular disease?
In adults with well-controlled hypertension without established cardiovascular disease, 6 months of low-dose colchicine significantly reduced inflammation (hsCRP) but did not improve arterial stiffness or blood pressure.
Mean Difference: -0.1 (95% CI -0.5–0.3)
p-value: p=0.53
Objective: Inflammation is part of the pathophysiology of hypertension. In this trial, we investigated whether anti-inflammatory treatment with colchicine would reduce arterial stiffness compared with placebo. Design and method: COHERENT was an investigator-initiated, randomized, double-blind, placebo-controlled trial of the effects of colchicine on arterial stiffness in adults with pharmacologically well-controlled hypertension without known cardiovascular disease. Eligible patients were randomized 1:1 to colchicine 0.5 mg daily or placebo. Assessment of arterial stiffness, echocardiography, and biochemistry was performed at baseline and after 6 months. The primary endpoint was the change in carotid-femoral pulse wave velocity (cfPWV). Secondary endpoints included blood pressure (BP), left ventricular mass index, and cardiac and inflammatory biomarkers. All endpoints were analyzed using linear mixed-effects models. Results: We screened 183 potential participants, of whom 150 were randomized (75 to colchicine and 75 to placebo) from August 2021 to July 2025. Mean age was 64.5 years (±8.0), 53 (35.3%) were female, mean systolic BP was 140.0mmHg (±16.5), and median hsCRP was 1.0 mg/L (0.5;2.1). At 6 months, no difference was found between the colchicine and placebo groups in change in cfPWV (between-group difference in δcfPWV -0.1m/s, 95%CI: -0.5 to 0.3m/s, p=0.53). Office-measured systolic BP decreased significantly more in the placebo group than in the colchicine group (between-group difference in δoffice-measured systolic BP 5.7mmHg, 95%CI: 1.0 to 10.5mmHg, 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). A prespecified subgroup analysis showed no differential effect of colchicine on cfPWV across the assessed subgroups. Low-dose colchicine was generally well-tolerated, and adverse events were primarily caused by gastrointestinal side effects and infections.Conclusions: In this population of adults with hypertension without other cardiovascular disease, 6 months of colchicine treatment did not significantly affect arterial stiffness. Colchicine significantly decreased hsCRP. The findings of this trial do not support a role for colchicine in improving vascular stiffness or blood pressure in patients with hypertension who do not have established cardiovascular disease.
Langhoff et al. (2026) conducted an RCT in Hypertension (n=150). Colchicine vs. Placebo was evaluated on Change in carotid-femoral pulse wave velocity (cfPWV) (MD -0.1, 95% CI -0.5 to 0.3, p=0.53). Colchicine 0.5 mg daily for 6 months did not significantly reduce arterial stiffness compared with placebo in adults with hypertension (mean difference in cfPWV -0.1 m/s; 95% CI -0.5 to 0.3; p=0.53).