Long-term effects of intensive blood-pressure lowering on arterial wallstiffness in hypertensive patients

Ichihara, Atsuhiro; Hayashi, Matsuhiko; Koura, Yukako; Tada, Yuko; Hirota, Nobuhisa; Saruta, Takao

doi:10.1016/s0895-7061(03)01004-5

Cited by 56 publications

(46 citation statements)

References 23 publications

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“…Over the shorter-term, the anti-hypertensive effect may cause fluctuations in BP and excessive tension in the arterial wall, perhaps by activating the sympathetic nervous system. Because the degree of BP lowering in the present study was not markedly more pronounced than in other studies (14,17), we hypothesize that vigorous BP lowering with an ARB can overwhelm the compensatory mechanisms and cause a significant decrease in baPWV.…”

Section: Discussioncontrasting

confidence: 67%

“…The PWV measurements, along with the heart rate (HR) and BP measurements, were made with a model BP-203RPE pulse pressure analyzer (Nihon Colin, Tokyo, Japan) by previously described methods (13,14). Briefly, pulse volume waveforms were recorded with plethysmographic sensors placed on the right brachial and on both posterior tibial arteries.…”

Section: Baseline Measurementsmentioning

confidence: 99%

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Selective Angiotensin Receptor Antagonism with Valsartan Decreases Arterial Stiffness Independently of Blood Pressure Lowering in Hypertensive Patients

Nakamura

Fujii²,

Hoshino³

et al. 2005

Hypertens Res

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Section: Discussioncontrasting

confidence: 67%

Section: Baseline Measurementsmentioning

confidence: 99%

Selective Angiotensin Receptor Antagonism with Valsartan Decreases Arterial Stiffness Independently of Blood Pressure Lowering in Hypertensive Patients

Nakamura

Fujii²,

Hoshino³

et al. 2005

Hypertens Res

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“…Laurent et al 28 found a 5 m/s difference in PWV more than doubled all cause and cardiovascular mortality in hypertensive patients and PWV can be improved with intensive BP lowering. 34 Reduction in systolic BP of 10 mmHg lowered the risk of myocardial infarction by 21% in the UK Prospective Diabetes Study and our results are in this range. 35 CRP, IL-6, tPA, PAI-1, sICAM-1 and sVCAM-1 In the present study, CRP decreased but IL-6 did not change.…”

Section: Discussionsupporting

confidence: 65%

Effect of weight loss on inflammatory and endothelial markers and FMD using two low-fat diets

et al. 2005

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OBJECTIVE: Cardiovascular disease is strongly associated with obesity and there is evidence that weight loss has positive effects on cardiovascular disease risk. The aims of this study were to compare meal replacements (MR) with a conventional low-fat diet as weight loss strategies and to examine the effect of weight loss on flow-mediated dilatation (FMD) and other markers of endothelial function in overweight Australians with raised triglycerides (TG) (42 mmol/l). RESEARCH METHODS: Subjects matched for age, gender, fasting plasma TG and body mass index were randomized to two low-fat high-carbohydrate weight loss strategies (both o6000 kJ), one using MR and the other a structured eating plan, control (C). Subjects followed both diets for 3 months. In total, 55 subjects completed the study. FMD, pulse wave velocity and blood pressure (BP) were measured at baseline and at 3 months, as were fasting blood samples for lipids, glucose, insulin, C reactive protein (CRP) and endothelium-derived factors. RESULTS: Mean weight loss was 6.373.7 kg (6.074.2 vs 6.6373.35 kg, MR vs C) with no difference between diet groups. TG, insulin, CRP, plasminogen activator inhibitor 1 (PAI-1) and soluble intracellular adhesion molecule-1 (sICAM1) fell after weight loss, but FMD did not change. Systolic BP fell by 8 mmHg and pulse wave velocity improved. DISCUSSION: In subjects with elevated TG, weight loss resulted in significant improvements in cardiovascular risk markers, particularly endothelium-derived factors (PAI-1 and sICAM1). However, FMD did not improve with weight loss.

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“…5,20 Briefly, pulse waves were recorded using sensors placed on the right brachial artery and both posterior tibial arteries. Electrocardiograms were obtained using electrodes placed at two points on the left arm and one point on the right arm.…”

Section: Measurementsmentioning

confidence: 99%

“…[1][2][3][4] We previously demonstrated that longterm, successful control of blood pressure (BP) with a target BP of o130/85 mmHg significantly decreases the PWV in hypertensive patients. 5 However, achieving this BP target is difficult for the hypertensive patients; some are unable to sufficiently control their BP and exhibit a high PWV, despite the best efforts of their physicians. Recent studies have shown that statins can be used to reduce BP in hypertensive patients with hypercholesterolaemia.…”

Section: Introductionmentioning

confidence: 99%

Long-term effects of statins on arterial pressure and stiffness of hypertensives

et al. 2004

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Although lowering blood pressure (BP) reduces aortic stiffness, achieving the recommended BP goal can be difficult. Recent studies have shown that short-term use of statins can reduce BP significantly. To determine the long-term effects of statins on BP and aortic stiffness, a single-blind randomized prospective study was performed on 85 hyperlipidaemic hypertensive patients whose BP was insufficiently controlled by antihypertensive therapy. Every 3 months, aortic stiffness was assessed by measuring pulse wave velocity (PWV). Patients were randomly allocated to groups treated with pravastatin, simvastatin, fluvastatin, or a nonstatin antihyperlipidaemic drug. No significant differences in patient characteristics, kinds of antihypertensive drugs, BP, ankle brachial index, PWV, or serum lipid, creatinine, or C-reactive protein levels were found between the four groups at the start of the study. During the 12-month treatment period, PWV did not change in the pravastatin group or nonstatin group, but it was transiently reduced in the simvastatin group and significantly decreased in the fluvastatin group, even though the doses of the statins used in this study were lower than the usually prescribed dose. All four antihyperlipidaemic drugs significantly decreased serum cholesterol levels without affecting BP, ankle brachial index, or serum triglyceride levels. The Creactive protein serum levels decreased significantly in the three statin groups but not in the nonstatin group. These results suggest that long-term use of fluvastatin by hyperlipidaemic hypertensive patients is associated with a significant reduction in aortic stiffness without any effect on BP.

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Long-term effects of intensive blood-pressure lowering on arterial wallstiffness in hypertensive patients

Abstract: Long-term intensive BP lowering in the hypertensive patients was associated with a significant reduction in aortic stiffness distinct from its acute depressor effect.

Cited by 56 publications

References 23 publications

Selective Angiotensin Receptor Antagonism with Valsartan Decreases Arterial Stiffness Independently of Blood Pressure Lowering in Hypertensive Patients

Selective Angiotensin Receptor Antagonism with Valsartan Decreases Arterial Stiffness Independently of Blood Pressure Lowering in Hypertensive Patients

Effect of weight loss on inflammatory and endothelial markers and FMD using two low-fat diets

Long-term effects of statins on arterial pressure and stiffness of hypertensives

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