Artery Research

Volume 8, Issue 4, December 2014, Pages 189 - 196

Value of haemodynamic profiling to the response of antihypertensive therapy

Authors
M. Serga, b, *, 1, J. Graggaberc, 1, P. Kampusa, b, M. Zaguraa, b, J. Kalsb, d, K. Mäki-Petäjäc, J. Cheriyanc, M. Zilmerb, J. Ehaa, e, C.M. McEnieryc, I.B. Wilkinsonc
aDepartment of Cardiology, University of Tartu, Tartu, Estonia
bInstitute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
cClinical Pharmacology Unit, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
dClinic of Vascular Surgery, Tartu University Hospital, Tartu, Estonia
eHeart Clinic, Tartu University Hospital, Tartu, Estonia
1

Equal contributors.

*Corresponding author. Department of Cardiology, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia. Tel.: +372 7318455. E-mail address: martin.serg@ut.ee (M.Serg).
Corresponding Author
M. Serg
Received 5 March 2014, Revised 1 May 2014, Accepted 30 July 2014, Available Online 22 September 2014.
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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Journal
Artery Research
Volume-Issue
8 - 4
Pages
189 - 196
Publication Date
2014/09/22
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2014.07.004How to use a DOI?
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.

Cite this article

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  -