Brachial Pressure–Independent Reduction in Carotid Stiffness After Long-Term Angiotensin-Converting Enzyme Inhibition in Diabetic Hypertensives

Hypertension and diabetes are associated with an increased arterial stiffness. A direct blood pressure–independent effect of angiotensin-converting enzyme inhibitors on arterial stiffness has never been unequivocally demonstrated. In this mechanistic study, we used an experimental design in which pa...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2006-07, Vol.48 (1), p.80-86
Main Authors: Tropeano, Anne-Isabelle, Boutouyrie, Pierre, Pannier, Bruno, Joannides, Robinson, Balkestein, Elisabeth, Katsahian, Sandrine, Laloux, Brigitte, Thuillez, Christian, Struijker-Boudier, Harry, Laurent, Stéphane
Format: Article
Language:English
Subjects:
Angiotensin-Converting Enzyme Inhibitors - pharmacology
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Blood Pressure - drug effects
Brachial Artery
Carotid Arteries - drug effects
Carotid Arteries - pathology
Carotid Arteries - physiopathology
Diabetes Complications - pathology
Diabetes Complications - physiopathology
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - pathology
Diabetes Mellitus, Type 2 - physiopathology
Dose-Response Relationship, Drug
Female
Humans
Hypertension - complications
Hypertension - drug therapy
Hypertension - pathology
Hypertension - physiopathology
Male
Middle Aged
Perindopril - pharmacology
Perindopril - therapeutic use
Single-Blind Method
Tunica Intima - pathology
Tunica Media - pathology
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Summary:Hypertension and diabetes are associated with an increased arterial stiffness. A direct blood pressure–independent effect of angiotensin-converting enzyme inhibitors on arterial stiffness has never been unequivocally demonstrated. In this mechanistic study, we used an experimental design in which patients responding to 1 month treatment with 4 mg perindopril were randomized double-blind to either 4 mg perindopril or 8 mg perindopril for 6 months. We determined carotid distensibility with echotracking and applanation tonometry at baseline and after the 7-month treatment period in 57 essential hypertensive patients with type 2 diabetes (age 63±7 years). We monitored ambulatory blood pressure at baseline and after treatment. After 7 months treatment, 24-hour ambulatory blood pressure significantly decreased, with no significant difference between 4 mg and 8 mg perindopril. Carotid distensibility increased more after 8 mg perindopril compared with 4 mg perindopril (8 mgfrom 13.1±5.9 to 16.0±6.7 kPa×10; 4 mgfrom 13.2±5.2 to 12.7±5.9 kPa×10; ANOVA, dose-period interaction, P
ISSN:0194-911X
1524-4563
DOI:10.1161/01.HYP.0000224283.76347.8c