Background: Arterial stiffness is an independent predictor of cardiovascular events and mortality in hypertensive patients. The influence of different antihypertensive drug classes on improving arterial stiffness beyond blood pressure reduction was not well demonstrated because of lack of power studies related to this subject. We aim to determine if the artery stiffness can be improved due to antihypertensive treatment independently of blood pressure lowering.

Methods: We conducted a meta-analysis of individual data from 15 randomized, controlled, double-blind, parallel group trials performed in our laboratory between 1987 and 1994. The primary endpoint was the changes in carotid-femoral pulse wave velocity (PWV) after treatment in 294 patients with mild to moderate essential hypertension untreated. Treatments tested were placebo (n = 88), angiotensin converting enzyme inhibitors (ACEI) (n = 75), calcium antagonists (CA) (n = 75), beta-blocker (n = 30), and diuretic (n = 26).

Results: In the short and long-term trials, PWV decreased significantly by −0.75 m/s and −1.3 m/s in the active treatment group compared to by +0.17 m/s and −0.44 m/s in the placebo group respectively. Active treatment was independently related to the changes in PWV and explained 5% and 4% of the variance in the short and long-term trials respectively. In the short-term trials, ACEI was more effective than CA and placebo on improving arterial stiffness. In the long-term trials, ACEI, CA, beta-blocker, and diuretic reduced significantly PWV compared to placebo.

Conclusion: Our study shows that antihypertensive treatment improves the arterial stiffness beyond its effect on blood pressure.