Background: Increasing evidence emphasizes the role of central pressure augmentation in the development of hypertension-related complications, and highlights the importance of targeting arterial stiffness and wave reflection with treatment.

Objective: Of this study was to evaluate the effects of the calcium antagonist barnidipine on large artery stiffness and wave reflection by means of separated wave analysis.

Methods: In twenty-one naif-treatment hypertensive patients, carotid artery mechanics was investigated at baseline and after 3 and 6 months of barnidipine therapy by a double-beam carotid ultrasound technique (Aloka SSD 5500) which provides simultaneous recording of diameter-derived pressure and flow velocity signals and allows wave intensity (WI) analysis. Indices of local arterial stiffness and wave reflection, and separated forward and backward pressures were estimated. Twenty normotensive subjects were also .

Results: Compared to controls, hypertensive patients had higher forward and backward pressures (137±17 vs 108±7 and 21±6 vs 17±5 mmHg, p< 0.05), augmentation index (AIx, 22.0±7.0 vs 13.1±5.2%, p<0.01) and pressure-dependent elastic modulus. After barnidipine, in hypertensive patients, office BP fell from 159±14/95±11 to 138±16/81±9 mmHg (p<0.001), due to a significant reduction in forward and backward pressures, and AIx decreased to 17.0±8.0% (p<0.01), without changes in arterial stiffness indices. A significant direct relationship between AIx and pulse pressure observed in hypertensive patients at baseline disappeared after therapy (r=0.45 before and 0.25 after therapy).

Conclusions. These data suggest that a reduced wave reflection during therapy with the calcium antagonist barnidipine is depending on its effects on muscular artery tone rather than on large artery stiffness.