Document Detail

Long-term reduction in aortic stiffness: a 5.3-year follow-up in routine clinical practice.
MedLine Citation:
PMID:  20683338     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Whether a direct blood pressure-independent reduction in aortic stiffness can occur after several years of antihypertensive treatment has never been unequivocally demonstrated.
METHOD: In this observational study, performed under conditions of routine clinical practice, we included 97 patients (age 63 ± 11 years) with treated essential hypertension who attended the outpatient hypertension clinic of a university hospital, had a significant blood pressure (BP) lowering under treatment before the first measurement of aortic stiffness, and had at least one additional measurement of aortic stiffness during follow-up. Aortic stiffness and carotid pulse pressure (PP) were determined through carotid-femoral pulse wave velocity (PWV) and applanation tonometry, respectively.
RESULTS: A linear mixed model showed that the reduction in PWV (from 14.2 ± 4.2 to 11.0 ± 2.4 m/s; P < 0.0001) over a long follow-up (mean delay 5.3 ± 1.3 years) was associated with a significant reduction in central SBP (from 132 ± 22 to 122 ± 16 mmHg; P < 0.0001) and central PP (from 59 ± 22 to 54 ± 14; P < 0.001), contrasting with a smaller change in brachial SBP (from 132 ± 17 to 129 ± 16 mmHg; P < 0.02) and no change in brachial PP. In multivariate analysis, the decrease in PWV (-0.70 ± 0.07 m/s per year; P < 0.0001) was only slightly explained by the reduction in mean blood pressure. By contrast, the decrease in central PP (-0.83 ± 0.41 mmHg per year; P = 0.043) was largely explained by the reduction in PWV.
CONCLUSION: These results indicate that a large and sustained decrease in aortic stiffness can be obtained in treated hypertensive patients under conditions of routine clinical practice. These changes likely represent a delayed response to the long-term normalization of BP and cardiovascular risk factors, through arterial remodeling.
Hafid Ait-Oufella; Cédric Collin; Erwan Bozec; Brigritte Laloux; Kim-Thanh Ong; Carole Dufouil; Pierre Boutouyrie; Stéphane Laurent
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-15     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  2336-41     Citation Subset:  IM    
Department of Pharmacology, European Hospital Georges Pompidou, France.
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MeSH Terms
Antihypertensive Agents / pharmacology*
Aorta / drug effects,  physiopathology*
Blood Pressure / drug effects
Carotid Arteries / pathology
Follow-Up Studies
Hypertension / drug therapy*
Linear Models
Manometry / methods
Middle Aged
Regression Analysis
Risk Factors
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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