Background: Angiotensin II (AT II) plays a key role in the development of vascular disease. Arterial stiffness is an important, independent predictor of cardiovascular risk. We investigated the long-term effects of selective AT₁receptor blockade with valsartan on arterial stiffness in patients with hypertension and metabolic syndrome (MS).

Study design and Methods: We have examined 30 patients (16 males and 14 females, aged 47±1 years, BMI 29–46 kg/m²) with the MS and mild essential hypertension in the double blind, placebo controlled study. We measured brachial blood pressure (BD, mmHg), brachial-ankle pulse wave velocity (baPWV, cm/s) and the augmentation index (Aix, %) by using tonometry, volume-plethysmography and Doppler ultrasonography before and after 20 weeks of treatment with valsartan (40 to 160 mg/day). Statistical significance was assessed by t-test or two-way ANOVA of the dose responses curves.

Results: After 20 weeks of treatment with valsartan, baPWV and Aix were reduced: mean delta systolic BP 12±1.6 mmHg (P = 0.02 vs. baseline), diastolic BP 5.1±1.8 mmHg (P < 0.0001 vs. baseline), mean BP 7.5±2.7 mmHg (P = 0.003 vs. baseline), baPWV 2.4±0.03 cm/s (P = 0.02 vs. baseline), Aix 23±8% (P = 0.002 vs. baseline). Delta baPWV was significantly higher in the group of female patients with the MS (F/M: 2.9±0.02 cm/s vs. 2.1±0.05 cm/s, P = 0.003).

Conclusion: AT₁receptor antagonism reduced the arterial stiffness in hypertensive patients with MS, and may provide new therapeutic strategies for cardiovascular risk reduction.