Effects of Anti-Hypertensive Monotherapy with Either Calcium Channel Blocker or Angiotensin Receptor Blocker on Arterial Stiffness, Central Hemodynamics, and Ventriculo-Arterial Coupling in Uncomplicated Hypertension Patients.
OBJECTIVE
This study is designed to investigate the effects of anti-hypertensive monotherapy [either calcium channel blocker (CCB) or angiotensin receptor blocker (ARB)] on pulsatile hemodynamic parameters in patients with uncomplicated hypertension.


METHODS
This is a longitudinal observational study. For simplicity, we included patients with uncomplicated hypertension who receivedmono anti-hypertensive therapy with ARB or CCB. Hemodynamic parameters including central arterial pressure (CAP), aortic characteristic impedance (Zc), augmentation index (AI), brachial-ankle pulse wave velocity (baPWV), heart-ankle pulse wave velocity (haPWV), cardiac ultrasonographic parameters and ventriculo-arterial (VA) coupling were measured before, 1 month and 3 months after treatment.


RESULTS
A total of 74 subjects were included in our study for analysis from 2007-2008. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and central systolic arterial pressure (CSAP) were significantly reduced 1 and 3 months after initiation of therapy. Among the pulsatile hemodynamic parameters, only the baPWV was significantly reduced (from1537.78 ± 200.63 cm/s to 1460.06 ± 186.09 cm/s to 1456.53 ± 196.03 cm/s, p for trend = 0.016). The haPWV only decreased with borderline significance (from 1015.38 ± 124.26 cm/s to 978.88 ± 126.55 cm/s to 967.99 ± 103.37 cm/s, p for trend = 0.041). The other pulsatile hemodynamic parameters remained unchanged before and after therapy. Subgroup analysis (age above or below52 years) showed that the baPWVwas significantly reduced only in the younger group.


CONCLUSIONS
Among the pulsatile hemodynamic parameters, only the baPWV was effectively reduced by either CCB or ARB. The improvement of PWV was more evident in younger subjects.


BACKGROUND
Arterial stiffness; Central arterial pressure; Hypertension; Pulse wave velocity; Ventriculo-arterial coupling.
Cardiovascular Center, Far Eastern Memorial Hospital;
Heng-Hsu
HH
Lin
Department, of Internal Medicine, En Chu Kong Hospital;
Chia-Sung
CS
Wang
Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Jiunn-Lee
JL
Lin
Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Juey-Jen
JJ
Hwang
Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Lian-Yu
LY
Lin