13.1 THE EFFECTS OF ALPHA 1-ADRENOCEPTOR-BLOCKADE AND ANGIOTENSIN CONVERTING ENZYME-INHIBITION ON INDICES OF AORTIC STIFFNESS MEASURED BY AN OSCILLOMETRIC SINGLE CUFF METHOD IN HYPERTENSION: THE DOXAZOSIN RAMIPRIL STUDY
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- Abstract
Objectives: To study whether inhibition of the renin-angiotensin-aldosterone system has effects on arterial stiffness beyond blood pressure (BP) reduction alone.
Methods: Hypertensive patients (age 54±12 years, 34% women) were randomized double-blind to ramipril (10 mg od, n=32) or doxazosin (8 mg od, n=26) for 12 weeks. Central aortic BP and pulse pressure (PP), aortic pulse wave velocity (PWV), and augmentation index (AIx) were assessed by a single cuff oscillometric cuff method (Arteriograph, Tensiomed). With PWV and Aix adjustments were made for potential confounding by height, age, gender, and baseline mean arterial pressure.
Results: Seated office brachial BP on inclusion was (mean values ± SD) 154±10/93±9 mmHg. Baseline central BP was 154±19/93±9 mmHg, central PP was 61±13 mmHg, PWV 9.0±2.1 m/s, AIx 45±13%, and transit time 61±12 ms. Treatment induced changes (mean values ± SEM) in central BP (−8±2/−8±1%; both P<0.01), aortic PP (−9±2 mmHg; P<0.01), PWV (−5.2±2.0%; P<0.05), AIx (−12±3%; P<0.01), and transit time (8±3 ms; P<0.01). Ramipril induced greater changes than doxazosin in central BP (−13±2/−11±2 vs −2±2 /−3±2%; all P<0.01), central PP (−16±3 vs −2±3 mmHg; P<0.01), and AIx (−18±4 vs −5±4%; P<0.05). The reductions in PWV were similar for ramipril and doxazosin (−6±3 vs −4±3%, respectively).
Conclusions: Both ramipril and doxazosin reduce BP and indices of arterial stiffness, with greater effects by ramipril on central BP and AIx. The results suggest that the single cuff oscillometric cuff technique can be used to evaluate effects of antihypertensive treatment on central BP and arterial function.
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TY - JOUR AU - Andreas Jekell AU - Majid Kalani AU - Thomas Kahan PY - 2016 DA - 2016/11/24 TI - 13.1 THE EFFECTS OF ALPHA 1-ADRENOCEPTOR-BLOCKADE AND ANGIOTENSIN CONVERTING ENZYME-INHIBITION ON INDICES OF AORTIC STIFFNESS MEASURED BY AN OSCILLOMETRIC SINGLE CUFF METHOD IN HYPERTENSION: THE DOXAZOSIN RAMIPRIL STUDY JO - Artery Research SP - 79 EP - 80 VL - 16 IS - C SN - 1876-4401 UR - https://doi.org/10.1016/j.artres.2016.10.110 DO - 10.1016/j.artres.2016.10.110 ID - Jekell2016 ER -