The impact of long-term diuretic monotherapy in aortic distensibility in well controled essential hypertensive patients

Abstract

The purpose of this study was to access the impact of Diuretics in aortic pulse wave velocity (PWV) in well-controlled essential hypertensive patients (EHP). Twelve EHP (mean age 52.2±6.9 years) were followed for a period of 18 months. Casual blood pressure (CBP) and PWV were evaluated in basal state and each 3 months after the beginning of the association of Hydrochlorothiazide 50 mg with Amiloride 5 mg. After the end of the study all patients were submitted to a last evaluation performed after a 7 days washout period (WP). Aortic distensibility was evaluated by carotid-femoral artery pulse wave velocity (PWV), measurements performed with a performed with manual mecanographic device. All patients had their BP well controlled with the medication (BP ≤140/90 mmHg). PWV showed a significative reduction after Diuretics BP normalization (PAS basal: 164.2±5.0 mmHg versus PAS 3 months: 139.8±5.1 mmHg; p<0.05. PAD basal: 96.5±2.5 mmHg versus PAD 3 months: 86.3±2.8 mmHg; p<0.05. PWV basal: 14.8±0.9 m/s versus PWV 3 months: 12.5±0.7 m/s; p<0.05) with a significative impairement of aortic distensibility through the 18 months of evaluation (PWV 3 months: 12.5±0.7 m/s versus PWV 18 months 14.2±0.6 m/s; p<0.05). After the washout period there was an increase of BP to a similar level of the basal state (PAS basal: 164.2±5.0 mmHg versus PAS WP: 164.8±5.6 mmHg; ns. PAD basal: 96.5±2.5 mmHg versus PAD WP: 97.6±2.5 mmHg; ns) with a significative rise in PWV compared to the basal evaluation (PWV basal: 14.8±0.9 m/s versus PWV WP: 15.6±0.8 m/s; p<0.05). Our results sugest that long-term Diuretic therapy could be effective in the BP control but may not provide a positive aortic structural impact.