The comparative effects of metoprolol and perindopril on aortic elasticity in young patients with prehypertension.
OBJECTIVE
It has been recently demonstrated that aortic elasticity is impaired in young patients with prehypertension compared with healthy controls. Accordingly, the purpose of the current study was to analyze the comparative effects of metoprolol and perindopril on aortic elasticity in young patients with prehypertension after 6 months of therapy.


METHODS
Fifty newly diagnosed patients with hypertension, who were in the prehypertension category according to the Joint National Committee seventh report, were enrolled in this blind, randomized, prospective study. After baseline clinical assessment, patients were randomly assigned to 4 mg daily dose of perindopril (group I, n=27, 18 male, median age=35 years) or 100 mg daily dose of metoprolol succinate (group II, n=28, 16 male, median age=33 years) for 6 months. Aortic strain, distensibility, and stiffness indexes were calculated from aortic diameters measured by echocardiography and blood pressures simultaneously measured by sphygmomanometry before and after treatment.


RESULTS
When the median aortic distensibility and strain indexes after 6 months of therapy were analyzed, aortic distensibility and strain indexes of both treatment arms were found to be significantly higher than those of the pretreatment period. In contrast, the posttreatment aortic stiffness indexes of both groups were significantly lower compared with those of pretreatment period. No statistical difference was found between pretreatment and posttreatment aortic elasticity parameters of both groups. Importantly, no statistically significant difference was found between the percentage change from baseline of metoprolol and perindopril groups regarding aortic elasticity parameters (aortic distensibility: 38.1 vs. 37.9%, respectively, P=0.86; aortic strain: 37.7 vs. 37.9%, respectively, P=0.44; stiffness index: -20.0 vs. -23.9%).


CONCLUSIONS
The current study revealed that early pharmacological intervention had strong beneficial effects on aortic elasticity in patients with prehypertension despite the fact that neither metoprolol nor perindopril was superior to the other.
Celik
Turgay
T
Department of Cardiology, Gulhane Military Medical Academy, School of Medicine, Etlik-Ankara, Turkey. benturgay@yahoo.com
Iyisoy
Atila
A
Acikel
Cengizhan
C
Yuksel
Cagdas
C
Celik
Murat
M
Yaman
Halil
H
Baysan
Oben
O
Isik
Ersoy
E
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001011:Aorta / Q000187:drug effects* / Q000503:physiopathology; D004548:Elasticity / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008790:Metoprolol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D020913:Perindopril / Q000627:therapeutic use*; D011446:Prospective Studies; D016037:Single-Blind Method
D000959:Antihypertensive Agents; D008790:Metoprolol; D020913:Perindopril