Beneficial Effect of Angiotensin II Type 1 Receptor Blocker Antihypertensive Treatment on Arterial Stiffness: The Role of Smoking

Authors

  • Gregory P. Vyssoulis MD, PhD,

    1. From the Hypertension Unit, First Department of Cardiology, University of Athens Medical School, Hippokration Hospital, and the First Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece
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  • Eva A. Karpanou MD, PhD,

    1. From the Hypertension Unit, First Department of Cardiology, University of Athens Medical School, Hippokration Hospital, and the First Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece
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  • Stella-Maria G. Kyvelou MD,

    1. From the Hypertension Unit, First Department of Cardiology, University of Athens Medical School, Hippokration Hospital, and the First Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece
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  • Dionysios N. Adamopoulos MD,

    1. From the Hypertension Unit, First Department of Cardiology, University of Athens Medical School, Hippokration Hospital, and the First Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece
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  • George C. Antonakoudis MD,

    1. From the Hypertension Unit, First Department of Cardiology, University of Athens Medical School, Hippokration Hospital, and the First Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece
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  • Alexandros D. Deligeorgis MD,

    1. From the Hypertension Unit, First Department of Cardiology, University of Athens Medical School, Hippokration Hospital, and the First Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece
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  • Dennis V. Cokkinos MD, PhD,

    1. From the Hypertension Unit, First Department of Cardiology, University of Athens Medical School, Hippokration Hospital, and the First Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece
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  • Christodoulos I. Stefanadis MD, PhD

    1. From the Hypertension Unit, First Department of Cardiology, University of Athens Medical School, Hippokration Hospital, and the First Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece
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Stella-Maria G. Kyvelou, MD, Hypertension Unit, First Department of Cardiology, Athens Medical School, Hippokration Hospital, First Cardiology Department of Onassis Cardiosurgery Center, 108, Vasilisis Sofia Avenue, PO 11526, Athens, Greece
E-mail: kyvelou113@yahoo.gr

Abstract

The purpose of the present study was to assess angiotensin receptor blocker (ARB) treatment on arterial stiffness in select hypertensive patients and define possible differences between smokers and nonsmokers. The authors evaluated 81 consecutive, nondiabetic patients (mean age, 52 years; 47 men) with uncomplicated essential hypertension with high plasma renin activity who were administered monotherapy with irbesartan, an ARB, at maximal dose. Patients were divided into smokers (n=24) and nonsmokers (n=57). Carotid-radial pulse wave velocity (PWVc-r), carotid-femoral pulse wave velocity (PWVc-f), and augmentation index (AIx) were measured before and 6 months after ARB antihypertensive treatment. All mean values of elastic effect indices were decreased after irbesartan monotherapy (AIx, from 26.3%to 21.2% [P<.01]; PWVc-f, from 7.7 m/s to 7.3 m/s [P<.05], and PWVc-r, from 8.9 m/s to 8.3 m/s [P<.001]). When comparing smokers vs nonsmokers, no difference was noted in AIx and PWVc-f change (P=not significant), while PWVc-r change was greater in smokers compared with nonsmokers (P<.05). Chronic ARB treatment may favorably affect arterial stiffness and wave reflections in hypertensive chronic smokers with elevated plasma renin levels.

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