Open AccessChanges in Aortic Pulse Wave Velocity in Hypertensive Postmenopausal Women: Comparison Between a Calcium Channel Blocker vs Angiotensin Receptor Blocker Regimen
Author(s) -
Hayoz Daniel,
Zappe Dion H.,
Meyer Marie A.R.,
Baek InYoung,
Kandra Albert,
Joly Marie P.,
Mazzolai Lucia,
Haesler Erik,
Periard Daniel
Publication year - 2012
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12004
Subject(s) - medicine , calcium channel blocker , angiotensin receptor , pulse wave velocity , regimen , postmenopausal women , cardiology , calcium , angiotensin ii , endocrinology , receptor , blood pressure
J Clin Hypertens (Greenwich) . 2012;14:773–778. ©2012 Wiley Periodicals, Inc. Postmenopausal women are at greater risk for hypertension‐related cardiovascular disease. Antihypertensive therapy may help alleviate arterial stiffness that represents a potential modifiable risk factor of hypertension. This randomized controlled study investigated the difference between an angiotensin receptor blocker and a calcium channel blocker in reducing arterial stiffness. Overall, 125 postmenopausal hypertensive women (age, 61.4±6 years; systolic blood pressure/diastolic blood pressure [SBP/DBP], 158±11/92±9 mm Hg) were randomized to valsartan 320 mg±hydrochlorothiazide (HCTZ) (n=63) or amlodipine 10 mg±HCTZ (n=62). The primary outcome was carotid‐to‐femoral pulse wave velocity (PWV) changes after 38 weeks of treatment. Both treatments lowered peripheral blood pressure (BP) (−22.9/−10.9 mm Hg for valsartan and −25.2/−11.7 mm Hg for amlodipine, P =not significant) and central BP (−15.7/−7.6 mm Hg for valsartan and −19.2/−10.3 mm Hg for amlodipine, P< .05 for central DBP). Both treatments similarly reduced the carotid‐femoral PWV (−1.9 vs −1.7 m/s; P =not significant). Amlodipine was associated with a higher incidence of peripheral edema compared with the valsartan group (77% vs 14%, P< .001). BP lowering in postmenopausal women led to a reduction in arterial stiffness as assessed by PWV measurement. Both regimens reduced PWV to a similar degree after 38 weeks of treatment despite differences in central BP lowering, suggesting that the effect of valsartan on PWV is mediated through nonhemodynamic effects.