Arterial Stiffness Predicts Hypertension Drug Response

Predicts control of systolic blood pressure

30 jan 2009-- Patients with hypertension and high levels of arterial stiffness are less likely to respond to antihypertensive drugs, researchers report in the Feb. 3 issue of the Journal of the American College of Cardiology.

Athanase Protogerou, M.D., from the University of Athens in Greece, and colleagues measured carotid-femoral pulse wave velocity (a measure of arterial stiffness) and blood pressure in 375 patients with hypertension who had been randomly assigned to atenolol or perindopril/indapamide.

After 12 months, the researchers found that patients in the highest tertile of baseline pulse wave velocity had the smallest blood pressure response to treatment and more need for increases in drug dose. Baseline pulse wave velocity was a significant predictor of systolic blood pressure control but not diastolic blood pressure control. The predictive value of pulse wave velocity on systolic blood pressure was independent of age, sex, mean blood pressure and cardiovascular risk factors, the authors report.

"These important findings suggest that aortic stiffness is a strong independent predictor of the likelihood of resistant hypertension and puts the aorta and its age-related degeneration at the center of the pathogenesis of resistant hypertension," Bryan Williams, M.D., from the University of Leicester School of Medicine in the United Kingdom, writes in an accompanying editorial.

Abstract
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Editorial