THE IMPACT OF ANTIHYPERTENSIVE DRUGS ON VASCULAR RIGIDITY AND ON THE GRADIENTS OF ARTERIAL STIFFNESS: A PILOT STUDY

Abstract

Objective: Damages to barosensitive organs would be induced by the reversal of the arterial stiffness gradient. Our team has demonstrated that administration of nitroglycerin reduces regional stiffness of muscle arteries (radial and femoral) without modifying aortic stiffness, resulting in increased aortic-brachial (AB-PWV) and aortic-femoral (AF-PWV) stiffness gradients. The aim of this project is to study the impact of antihypertensive treatment on arterial stiffness, particularly on stiffness gradients. Design and method: This pilot study was performed in 19 hypertensive patients (age: 71 ± 11 years, men: 85%). The aortic, brachial and femoral stiffnesses were respectively measured by the carotid-femoral (cf-PWV), carotid-radial (cr-PWV) and femoral-dorsalis pedis (fd-PWV) pulse wave velocity during 2 visits: with and without medication for high blood pressure. During the drug-free visit, patients were to stop taking their antihypertensive drugs 2-3 days before their assessment, depending on their condition. The AB-PWV and AF-PWV ratios were obtained by dividing cf-PWV by cr-PWV or fd-PWV respectively. Results: At the visit without antihypertensive drugs, the cf-PWV, cr-PWV and fd-PWV were respectively 12.91 ± 0.65 m/s, 9.6 ± 0.4 m/s and 10.3 ± 0.3 m/s, resulting in an AB- ratio PWV of 1.37 ± 0.09 and an AF-PWV ratio of 1.21 ± 0.07. At the visit with medication, a significant decrease in mean arterial pressure of 9.5 mmHg (p < 0.001) was observed. In addition, reductions in cr-PWV of 0.79 m/s (p = 0.034) and fd-PWV of 0.45 m/s (p = 0.29) were noted, with no statistically significant change in cf-PWV (p = 0.83), leading to a non-significant increase in the AB-PWV (p = 0.21) and AF-PWV (p = 0.52) ratios. Conclusions: The preliminary data from this pilot project, although statistically non-significant, evolves in the same direction as those obtained with the administration of nitroglycerin. Indeed, there is a decrease in brachial and femoral stiffness leading to an increase in the gradients, which could have consequences for the microcirculation. These results suggest an impact of antihypertensive drugs on peripheral arteries and the vascular stiffness gradients, which could be confirmed with the continuation of this project on a larger sample.