title: Arterial Destiffening in Previously Untreated Mild Hypertensives After 1 Year of Routine Clinical Management.
abstract: BACKGROUND
  Arterial stiffness, measured with pulse wave velocity (PWV), is now classified as a marker of target organ damage (TOD) alongside left ventricular hypertrophy and moderately increased albuminuria. Interventional studies on treated hypertensive patients have shown that PWV could be improved. Our aim was to assess changes in arterial stiffness after 1 year of routine clinical practice in never-treated hypertensive patients.
  
  
  METHODS
  We studied 356 never-treated patients with suspected hypertension. After standard clinical assessment during which presence of TOD was evaluated, hypertension diagnosis was confirmed in 231 subjects who subsequently received standard routine care. Both hypertensive and the 125 controls came back for a follow-up visit after 1 year.
  
  
  RESULTS
  Hypertensive patients were slightly older (46 ± 12 vs. 50 ± 12 years, P < 0.001), with higher mean arterial pressure (MAP)-adjusted PWV compared to controls (8.6 ± 2.0 vs. 8.0 ± 1.7 m/s, P < 0.001) and 47% of them presented 1 or more TOD. After 1 year of treatment, MAP was similar in both groups (94.9 vs. 96.2 mm Hg; P = ns), but adjusted PWV remained significantly higher in the hypertensive patients (7.8 ± 1.4 vs. 8.3 ± 1.7 m/s, P = 0.004). The prevalence of elevated PWV was reduced from 20% to 12%. All antihypertensive drugs achieved the same blood pressure (BP) and PWV reduction with the exception of vasodilating beta-blockers which gave slightly better results probably due to heart rate reduction.
  
  
  CONCLUSIONS
  BP reduction in newly diagnosed hypertensive patients improves arterial stiffness within a year of real-life clinical practice. Patients with the highest PWV and the largest reduction of BP "destiffened" the most whatever antihypertensive class was used.
authors.affiliation: Department of Internal Medicine, Hypertension Clinics of Sagunto Hospital, Sagunto (Valencia), Spain.|Universidad CEU Cardenal Herrera, Área de Ciencias de la Salud, Castellón, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Rodilla
authors.affiliation: Pulse Wave Consulting, Saint Leu La Foret, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Millasseau
authors.affiliation: Department of Internal Medicine, Hypertension Clinics of Sagunto Hospital, Sagunto (Valencia), Spain.|Universidad CEU Cardenal Herrera, Área de Ciencias de la Salud, Castellón, Spain.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Costa
authors.affiliation: Department of Internal Medicine, Hypertension Clinics of Sagunto Hospital, Sagunto (Valencia), Spain.|Facultad de Medicina, University of Valencia, Valencia, Spain.
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Pascual
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects*; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D063177:Pulse Wave Analysis; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D059289:Vascular Stiffness / Q000187:drug effects*
chemical_list: D000959:Antihypertensive Agents
keywords: arterial stiffness; blood pressure; hypertension; pulse wave velocity; real-life clinical practice; target organ damage