Changes in Aortic Pulse Wave Velocity in Hypertensive Postmenopausal Women: Comparison Between a Calcium Channel Blocker vs Angiotensin Receptor Blocker Regimen
Version of Record online: 12 SEP 2012
© 2012 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 14, Issue 11, pages 773–778, November 2012
How to Cite
Hayoz, D., Zappe, D. H., Meyer, M. A.R., Baek, I., Kandra, A., Joly, M. P., Mazzolai, L., Haesler, E. and Periard, D. (2012), Changes in Aortic Pulse Wave Velocity in Hypertensive Postmenopausal Women: Comparison Between a Calcium Channel Blocker vs Angiotensin Receptor Blocker Regimen. The Journal of Clinical Hypertension, 14: 773–778. doi: 10.1111/jch.12004
- Issue online: 5 NOV 2012
- Version of Record online: 12 SEP 2012
- Manuscript received: May 6, 2012; revised: July 17, 2012; accepted: July 29, 2012
J Clin Hypertens (Greenwich). 2012;14:773–778. ©2012 Wiley Periodicals, Inc.
Postmenopausal women are at greater risk for hypertension-related cardiovascular disease. Antihypertensive therapy may help alleviate arterial stiffness that represents a potential modifiable risk factor of hypertension. This randomized controlled study investigated the difference between an angiotensin receptor blocker and a calcium channel blocker in reducing arterial stiffness. Overall, 125 postmenopausal hypertensive women (age, 61.4±6 years; systolic blood pressure/diastolic blood pressure [SBP/DBP], 158±11/92±9 mm Hg) were randomized to valsartan 320 mg±hydrochlorothiazide (HCTZ) (n=63) or amlodipine 10 mg±HCTZ (n=62). The primary outcome was carotid-to-femoral pulse wave velocity (PWV) changes after 38 weeks of treatment. Both treatments lowered peripheral blood pressure (BP) (−22.9/−10.9 mm Hg for valsartan and −25.2/−11.7 mm Hg for amlodipine, P=not significant) and central BP (−15.7/−7.6 mm Hg for valsartan and −19.2/−10.3 mm Hg for amlodipine, P<.05 for central DBP). Both treatments similarly reduced the carotid-femoral PWV (−1.9 vs −1.7 m/s; P=not significant). Amlodipine was associated with a higher incidence of peripheral edema compared with the valsartan group (77% vs 14%, P<.001). BP lowering in postmenopausal women led to a reduction in arterial stiffness as assessed by PWV measurement. Both regimens reduced PWV to a similar degree after 38 weeks of treatment despite differences in central BP lowering, suggesting that the effect of valsartan on PWV is mediated through nonhemodynamic effects.