Artikel
Effects of Valsartan and Metoprolol on large artery function in hypertensive patients
Wirkungen von Valsartan und Metoprolol auf funktionelle Wandeigenschaften großer Arterien bei hypertensiven Patienten
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Autoren
Veröffentlicht: | 11. November 2004 |
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Gliederung
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Background
Even mild hypertension is associated with substantial alterations of arterial vessel wall function. Several observations suggest that antihypertensive drugs may have differential, pressure-independent effects on arterial function. We compared the effects of a 12 weeks therapy with the AT1 receptor antagonist valsartan (Val) versus the beta blocker metoprolol (Met) on brachial artery endothelium-dependent flow-mediated dilatation (FMD) and large artery distensibility (DC) in mildly hypertensive patients.
Methods
68 mildly hypertensive patients (37 male, 31 female, 46±1 years) were randomized to Val (80-160 mg/d) or Met (50-100 mg/d). Hydrochlorothiazide (12,5 mg/d) was added if the target blood pressure of <140/90 mmHg was not achieved. At randomization and after 3 months of therapy, sitting systolic and diastolic blood pressure (SBP/DBP) were measured, FMD and endothelium independent nitroglycerine-induced brachial artery dilatation (NMD) and brachial and carotid artery DC were assessed using an echo-tracking device. Carotid and femoral pulse contour was registered with applanation tonometry to measure aortic pulse wave velocity (PWV) and to calculate carotid artery isobaric DC (DCI) at rest and during sympathetic stimulation (cold pressor test).
Results
52 patients were available for per protocol analysis. Data in the table are mean ± SEM. Trends did not differ significantly between groups for any parameter.
Conclusions
Blood pressure reduction was comparable in patients treated with valsartan and metoprolol. There were mild effects on endothelial function which did not differ significantly between the two antihypertensive treatment regimens. Neither drug did significantly influence large artery elastic wall properties.