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Effect of telmisartan on arterial distensibility and central blood pressure in patients with mild to moderate hypertension and Type 2 diabetes mellitus
Roland Asmar
The Cardiovascular Institute, Paris, France, ra{at}icv.org
Arterial wall stiffness is an important independent risk factor for cardiovascular disease in hypertensive patients, which is further exacerbated by co-existent diabetes mellitus. Increased arterial stiffness is directly associated with an increase in pulse wave velocity (PWV) and indirectly with increased central and peripheral blood pressure. Following a two-week placebo run-in period, 27 patients with mild to moderate essential hypertension and Type 2 diabetes mellitus, were randomised to once daily treatment with either telmisartan 40 mg or placebo for three weeks, and after a two-week washout period, crossed-over to the alternative treatment for a further three weeks. Carotid/femoral and carotid/radial PWV were measured non-invasively using the automatic Complior ® device, and central parameters (central blood pressure, pulse contour analysis, and augmentation index) were measured using the SphygmoCor ® system, at the start and end of each treatment period. Compared with placebo, treatment with telmisartan significantly reduced carotid/femoral PWV (mean adjusted treatment difference -0.95 m/s, 95% confidence intervals: -1.67, -0.23 m/s, p=0.013), as well as peripheral and central diastolic, systolic and pulse pressure. In conclusion, the results of this study show that telmisartan is effective in reducing arterial stiffness in hypertensive patients with Type 2 diabetes mellitus, and may potentially have beneficial effects on cardiovascular outcomes, beyond blood-pressure lowering effects, in this patient group.
Key Words: arterial stiffness • pulse wave velocity • angiotensin II receptor blocker
References
- Messerli FH, Grossman E., Goldbourt U. Antihypertensive therapy in diabetic hypertensive patients. Am J Hypertens 2001;14:12S-16S.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Hansson L., Zanchetti A., Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet 1998;351:1755-62.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- O'Rourke MF, Mancia G. Arterial stiffness. J Hypertens 1999;17:1-4.[Web of Science][Medline]
[Order article via Infotrieve]
- Laurent S., Boutouyrie P., Asmar R. et al.Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001;37:1236-41.[Abstract/Free Full Text]
- van Popele NM, Grobbee DE, Bots ML et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke 2001;32:454-60.[Abstract/Free Full Text]
- Cockroft JR, Webb DJ, Wilkinson IB Arterial stiffness, hypertension and diabetes mellitus. J Hum Hypertens 2000; 14:377-80.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Safar ME Systolic blood pressure, pulse pressure and arterial stiffness as cardiovascular risk factors. Curr Opin Nephrol Hypertens 2001;10:257-61.[Web of Science][Medline]
[Order article via Infotrieve]
- Safar ME Haemodynamic changes in elderly hypertensive patients. Am J Hypertens 1993;6:20S-23S.[Medline]
[Order article via Infotrieve]
- Dart AM, Kingwell BA Pulse pressure - a review of mechanisms and clinical relevance. J Am Coll Cardiol 2001;37:975-84.[Abstract/Free Full Text]
- Asmar R., Benetos A.,Topouchian J. et al.Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies. J Hypertens 1995;26:485-90.
- Asmar RG Noninvasive evaluation of arterial abnormalities in hypertensive patients. Pathol Biol (Paris) 1999;47:685-95.[Web of Science][Medline]
[Order article via Infotrieve]
- Yasmin, Brown MJ.Similarities and differences between augmentation index and pulse wave velocity in the assessment of arterial stiffness. Quart J Med 1999;92:595-600.[Abstract/Free Full Text]
- Winer N., Weber MA, Sowers JR The effect of antihypertensive drugs on vascular compliance. Curr Hypertens Rep 2001;3:297-304.[Medline]
[Order article via Infotrieve]
Journal of Renin-Angiotensin-Aldosterone System, Vol. 2, No. 2 suppl,
S8-S11 (2001)
DOI: 10.3317/jraas.2001.031
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