Aim: Carotid-femoral pulse wave velocity (PWV) is a strong independent predictor of cardiovascular morbidity and mortality. The aim of the study was to evaluate treatment-induced changes in PWV in hypertensive subjects treated to target clinic BP (CBP).

Methods: Pts with grade I-II arterial hypertension were treated to target CBP<140/90 mmHg with combination of RAAS-inhibitors and amlodipine for 1 yr. Baseline BP was 163,4±8,1/100,9±4,2 mmHg;achieved BP 123,7±9,7/76,8±6,7mmHg. Central BP and PWV were measured before treatment and after 8mo of target CBP achievement and maintenance.

Results: 47 pts (20 men, age 58,9±9,0 yrs;4 smokers;6 diabetics) achieved and maintained target CBP. In 11 (23%) pts PWV decreased by≥ 1m/s from baseline(G1), in 15 (32%) pts - unchanged(G2), in 21 (45%) - increased by ≥ 1m/s from baseline(G3). The groups were similar by age and all risk factors. The baseline (154,8±7,3/91,7±10,2, 152,7±12,1/92,3±8,3 and 149,3±8,1/91,7±6,04mmHg) and achieved CBP (128,4±7,26/80,1±4,55, 125,6±11,4/79,2±6,5 and 126,6±8,4/78,5±5,97 mmHg) were similar. There was significant difference in baseline PWV (G1 15,9±2,5 vsG2 13,6±1,9 vsG3 10,9±1,7 m/s,p<0.05), but at the end of the study PWV was similar: respectively,13,0±2,1,13,6±1,9 and 13,4±1,9m/s. 72,7% pts in G1 and 66,7% in G2 received the highest recommended doses of RAAS-inhibitors and A10mg vs 28,6% in G3 (Pearsonχ²=9,0;p<0,05). Indapamide SR 1,5mg was added in 36,4%, 20% and 9,5%, respectively. Correlation and multiple regression analysis revealed the association between PWV decrease and doses of RAAS-inhibitors and amlodipine (r=−0,5,β=−0,45,p<0,05)

Conclusion: There is modulating effect of target pressure achievement on PWV in hypertensive subjects. PWV reduction is associated with higher doses of RAAS inhibitors and amlodipine.