The effects of antihypertensive therapy on carotid vascular structure in man.
OBJECTIVE
An increased carotid intima-media thickness (IMT) has been found to be associated with a number of cardiovascular risk factors such as age, hypertension, cigarette smoking, hypercholesterolaemia and left ventricular hypertrophy. Our objective was to assess whether carotid intima-media thickness in hypertensive patients could be reduced by antihypertensive therapy.


METHODS
13 hypertensive patients, 10 previously untreated, were examined using carotid ultrasonography and echocardiography at baseline and then at 8 weeks and 39 weeks after commencement of antihypertensive therapy with ramipril and the second-line addition of felodipine.


RESULTS
By the end of the study significant regression of IMT (0.1(0.05-0.16) mm, F-value 10.2, P < 0.01) and left ventricular mass index had occurred (25(10.7-39.3) g/m2, F-value 9.7, P < 0.01). The reduction in IMT was significantly related to the reduction in mean arterial pressure, r = 0.55, P = 0.05).


CONCLUSIONS
Antihypertensive therapy with ramipril and felodipine causes regression of IMT in hypertensive patients, probably chiefly through blood pressure reduction. Large prospective studies are required to assess whether a reduction in IMT results in a reduction in morbidity and mortality.
Mayet
J
J
Peart-Rose Clinic, St. Mary's Hospital Medical School, Imperial College of Science, Technology and Medicine, London, UK.
Stanton
A V
AV
Sinclair
A M
AM
MacKay
J
J
Shahi
M
M
Foale
R A
RA
Nicolaides
A
A
Poulter
N R
NR
Sever
P S
PS
Thom
S A
SA
D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D004359:Drug Therapy, Combination; D015736:Felodipine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D017257:Ramipril / Q000627:therapeutic use*; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology*; D014463:Ultrasonography
D017257:Ramipril; D015736:Felodipine