Effects of various antihypertensive drugs on arterial stiffness in elderly patients with essential hypertension

Objective To evaluate the effects of various antihypertensive drug therapy on arterial stiffness in elderly patients with essential hypertension(EH). Methods Sixty male patients with EH aged 60 years or older were randomly divided into the group treated with valsartan (80 mg once daily),benazepril(10 mg once daily)or nifedipine(20 mg twice daily)for 3 months. Brachial-ankle pulse wave velocity (baPWV)and blood pressures (BP)were measured in baseline and 3 months after treatment respectively. Results BP were decreased significantly in all three groups with significant difference in reduction of DBP(△DBP) and PP(△PP)between nifedipine group and the other two groups(-40.1±11.3 vs-16.6±5.5,-14.6±4.2 mmHg;-10.0±19.3 vs -28.8±6.6,-25.7±6.5 mmHg,P0.01). A significant reduction of the baPWV(△baPWV) were found in patients treated by valsartan and benazepril(-401±9,-280±97cm/s,respectively)with no changes in patients treated by nifedipine -11±127 cm/s(P0.01). Statistical analysis showed △baPWV and △PP were significantly correlated in all sixty patients(r=0.64,P0.001). In the benazepril or nifedipine group,△baPWV were significantly correlated with at least one of the parameters of BP change (△PP,△SBP,△DBP), whereas in the valsartan group no such correlation was noted. Conclusions Compared with benazepril and nifedipine,valsartan may further decrease arterial stiffness independently of blood pressure lowering in elderly patients with EH.