Impact of arterial stiffness reduction on urinary albumin excretion during antihypertensive treatment: the Japan morning Surge-1 study.
OBJECTIVE
There has been no report investigating the impact of the arterial stiffness reduction induced by antihypertensive medications on the improvement of target organ damage in hypertension. The aim of this study was to assess the association of the change in pulse wave velocity (PWV) with that in urinary albumin excretion as a measure of renal damage.


METHODS
We studied 404 treated hypertensive patients (mean age, 70.5 +/- 9.5 years), who were allocated to either an active treatment group (doxazosin and atenolol when needed) or a control group. Blood pressure, urinary albumin-to-creatinine ratio (UACR), and brachial-ankle PWV (baPWV) were measured at baseline and after 6 months of treatment.


RESULTS
In the total population, home/office SBP, UACR, and baPWV decreased significantly from the baseline. In multivariate regression analyses, DeltabaPWV was significantly associated with DeltaUACR, independent of Deltahome SBP (beta = 0.21, P < 0.001). When the patients were divided into a group with DeltabaPWV of at least 0 cm/s (positive DeltaPWV) and a group with DeltabaPWV of less than 0 cm/s (negative DeltaPWV), the reduction of UACR was greater in the latter group, even after adjustment for the covariates including the change in home SBP. These results were essentially the same when office SBP was entered in place of home SBP, and similar both in the active treatment group and the control group.


CONCLUSIONS
These findings suggest that the arterial stiffness reduction induced by antihypertensive medications is associated with the improvement of renal damage, independent of home/office SBP reduction.
Matsui
Yoshio
Y
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. yoshio@jichi.ac.jp
Eguchi
Kazuo
K
Shibasaki
Seiichi
S
Ishikawa
Joji
J
Hoshide
Satoshi
S
Shimada
Kazuyuki
K
Kario
Kazuomi
K
D000368:Aged; D000419:Albuminuria / Q000139:chemically induced* / Q000652:urine; D055109:Ankle Brachial Index; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use*; D001783:Blood Flow Velocity / Q000187:drug effects; D001916:Brachial Artery / Q000187:drug effects / Q000503:physiopathology; D015331:Cohort Studies; D017292:Doxazosin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004548:Elasticity / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D008297:Male; D011673:Pulsatile Flow / Q000187:drug effects; D012189:Retrospective Studies
D000959:Antihypertensive Agents; D001262:Atenolol; D017292:Doxazosin