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 50mg 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 impairment 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.
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