Cross-sectional characterization of all classes of antihypertensives in terms of central blood pressure in Japanese hypertensive patients.
BACKGROUND
Central blood pressure (CBP) has been reported to be superior to brachial blood pressure (BP) as a cardiovascular risk predictor in hypertensive patients; however, the effects of antihypertensives on CBP have not been fully examined. This cross-sectional hypothesis-generating study aimed to tentatively characterize all classes of antihypertensives in relation to CBP.


METHODS
Calibrated tonometric radial artery pressure waveforms were recorded using an automated device in 1,727 treated hypertensive patients and 848 nonhypertensive (non-HT) participants. Radial artery late systolic BP (SBP) has been reported to reflect central SBP. The difference between late and peak SBPs (DeltaSBP2) was assessed with linear regression model-based adjustments. Separate regression models for DeltaSBP2 were constructed for both participant groups as well as specified sub-populations.


RESULTS
DeltaSBP2 was 3.3 mm Hg lower in patients treated with any single-vasodilating (VD) antihypertensive agent without significant interclass difference than with non-VD agents, and was 2.0 mm Hg lower than estimated in nonhypertensive subjects. Combinations of two vasodilators were 6.6 and 2.9 mm Hg lower in DeltaSBP2 than nonvasodilator combinations and nonhypertensive subjects, respectively (P < 0.001 for all comparisons). Nonvasodilators and their combination showed high DeltaSBP2, 1.1 and 3.7 mm Hg higher than in nonhypertensive subjects (P < 0.001 for both). Additional adjustment of the pulse rate reduced high DeltaSBP2 with beta-blockers (betaBLs).


CONCLUSIONS
This cross-sectional observation suggests that vasodilatory antihypertensives lower CBP independently of peripheral BP levels without evident class-specific differences, whereas nonvasodilators may raise CBP.
Miyashita
Hiroshi
H
Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. hrsm@jichi.ac.jp
Aizawa
Akira
A
Hashimoto
Junichiro
J
Hirooka
Yoshitaka
Y
Imai
Yutaka
Y
Kawano
Yuhei
Y
Kohara
Katsuhiko
K
Sunagawa
Kenji
K
Suzuki
Hiromichi
H
Tabara
Yasuharu
Y
Takazawa
Kenji
K
Takenaka
Tsuneo
T
Yasuda
Hisayo
H
Shimada
Kazuyuki
K
D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000145:classification* / Q000494:pharmacology*; D044466:Asian People; D001794:Blood Pressure / Q000187:drug effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007564:Japan; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000187:drug effects / Q000503:physiopathology; D014665:Vasodilator Agents / Q000145:classification* / Q000494:pharmacology*
D000959:Antihypertensive Agents; D014665:Vasodilator Agents