title: Cross-sectional characterization of all classes of antihypertensives in terms of central blood pressure in Japanese hypertensive patients.
abstract: 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.
authors.affiliation: Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. hrsm@jichi.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyashita
authors.forename: Akira
authors.initials: A
authors.lastname: Aizawa
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Hirooka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Kawano
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kohara
authors.forename: Kenji
authors.initials: K
authors.lastname: Sunagawa
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Tabara
authors.forename: Kenji
authors.initials: K
authors.lastname: Takazawa
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takenaka
authors.forename: Hisayo
authors.initials: H
authors.lastname: Yasuda
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimada
mesh_terms: 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*
chemical_list: D000959:Antihypertensive Agents; D014665:Vasodilator Agents