Value of haemodynamic profiling to the response of antihypertensive therapy
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- DOI
- 10.1016/j.artres.2014.07.004How to use a DOI?
- Keywords
- Antihypertensive agents; Hypertension; Vascular stiffness; Haemodynamics
- Abstract
Background: Essential hypertension is characterised by alterations in haemodynamics. Hence haemodynamic profiling could lead to improved blood pressure (BP) control in these patients. We tested if baseline haemodynamic indices predict the BP lowering effects of different classes of antihypertensive drugs in hypertensive patients.
Methods: In this double-blind placebo-controlled crossover study we randomised 53 hypertensive patients to receive doxazosin 4 mg, candesartan 16 mg, bisoprolol 5 mg, isosorbide mononitrate (ISMN) 50 mg, and placebo daily for 6 weeks. Brachial and central BP, augmentation index (AIx), aortic pulse wave velocity (aPWV), stroke volume (SV), cardiac output (CO), peripheral vascular resistance (PVR), and pulse pressure amplification (PPA) were measured at baseline and after each drug.
Results: Baseline AIx and PPA determined BP reduction with antihypertensive therapy, particularly with bisoprolol. In patients with low baseline AIx (1.7–28.9%) and high PPA (1.22–1.87), bisoprolol had a weak antihypertensive effect, while the opposite was observed in patients with high AIx (36.3–48.2%) and low PPA (1.05–1.11). With candesartan, BP reduction was the largest, regardless of baseline AIx or PPA levels.
Conclusions: Our study suggests that ARBs reduce BP the most irrespective of the underlying haemodynamic profile. Antihypertensive therapy guided by AIx and PPA may have some merit in the guidance of antihypertensive drug treatment, particularly if beta-blockers are considered for treatment. However, larger studies are needed to confirm these results.
Clinical Trials Registry number: EudraCT 2006-006981-40.
- Copyright
- © 2014 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
- Open Access
- This is an open access article distributed under the CC BY-NC license.
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TY - JOUR AU - M. Serg AU - J. Graggaber AU - P. Kampus AU - M. Zagura AU - J. Kals AU - K. Mäki-Petäjä AU - J. Cheriyan AU - M. Zilmer AU - J. Eha AU - C.M. McEniery AU - I.B. Wilkinson PY - 2014 DA - 2014/09/22 TI - Value of haemodynamic profiling to the response of antihypertensive therapy JO - Artery Research SP - 189 EP - 196 VL - 8 IS - 4 SN - 1876-4401 UR - https://doi.org/10.1016/j.artres.2014.07.004 DO - 10.1016/j.artres.2014.07.004 ID - Serg2014 ER -