Effect of angiotensin ii receptor blockade on arterial stiffness: beyond blood pressure reduction.
We compared the effect of losartan (50 mg/day) to hydrochlorthiazide (12.5 mg/day) on blood pressure (BP) and arterial stiffness in 11 untreated hypertensive patients aged 47 to 69 years in a 4-week single blind randomized crossover study with an intervening 4-week washout period. Both drugs produced a significant (P <.001) and similar decrease in brachial BP. Only losartan induced a significant decrease in arterial wave reflection (P <.0001), with a preferential reduction in aortic (P <.001) compared to brachial pulse pressure. Losartan also significantly increased pulse pressure amplification and reduced pulse wave velocity. These results suggest that an AT(1) receptor antagonist induces a BP independent decrease in aortic stiffness and arterial wave reflection.
Mahmud
Azra
A
Department of Pharmacology and Therapeutics, Trinity Centre and Hypertension Clinic, St. James's Hospital, Dublin, Ireland.
Feely
John
J
D000368:Aged; D000804:Angiotensin II / Q000037:antagonists & inhibitors*; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001011:Aorta / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects*; D001916:Brachial Artery / Q000503:physiopathology; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000494:pharmacology* / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D019808:Losartan / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014655:Vascular Resistance / Q000187:drug effects*
D000959:Antihypertensive Agents; D006852:Hydrochlorothiazide; D000804:Angiotensin II; D019808:Losartan