Comparable effect of aliskiren or a diuretic added on an angiotensin II receptor blocker on augmentation index in hypertension: a multicentre, prospective, randomised study

Miyoshi, Toru; Murakami, Takashi; Sakuragi, Satoru; Doi, Masayuki; Nanba, Seiji; Mima, Atsushi; Tominaga, Yoshihiro; Oka, Takahiro; Kajikawa, Yutaka; Nakamura, Kazufumi; Ito, Hiroshi

doi:10.1136/openhrt-2017-000591

Cited by 7 publications

(6 citation statements)

References 24 publications

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“…After having reviewed the title and abstract, 3,845 were excluded. Of the 162 full-text articles retrieved, 142 original articles were excluded for various reasons ( Figure 1 ), leaving 20 eligible original articles in the analysis ( Chen et al, 1995 ; Klingbeil et al, 2002 ; Ariff et al, 2006 ; Dart et al, 2007 ; Jiang et al, 2007 ; Schneider et al, 2008 ; Mackenzie et al, 2009 ; Matsui et al, 2009 ; Boutouyrie et al, 2010 ; Doi et al, 2010 ; Vitale et al, 2012 ; Kubota et al, 2013 ; Radchenko et al, 2013 ; Kim et al, 2014 ; Koumaras et al, 2014 ; Ghiadoni et al, 2017 ; Jekell et al, 2017 ; Miyoshi et al, 2017 ; Webster et al, 2017 ; Choi et al, 2018 ), comparing RAS inhibitors ( n = 21) or CCBs ( n = 6) with diuretics, β-blockers, or an α-blocker ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Antihypertensive Treatment and Central Arterial Hemodynamics: A Meta-Analysis of Randomized Controlled Trials

Cheng

Xia

et al. 2021

Front. Physiol.

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Background: Antihypertensive treatment may have different effects on central arterial hemodynamics. The extent of the difference in effects between various antihypertensive drugs remains undefined.Methods: We conducted a systematic review and meta-analysis of randomized controlled trials that explored the effects of antihypertensive agents on both central and peripheral systolic blood pressure (SBP) and pulse pressure (PP) or central augmentation index, with a special focus on the comparison between newer [renin-angiotensin-aldosterone system (RAS) inhibitors and calcium-channel blockers (CCBs)] and older antihypertensive agents (diuretics and β- and α-blockers).Results: In total, 20 studies (n = 2,498) were included. Compared with diuretics (10 studies), β-blockers (16 studies), or an α-blocker (1 study), RAS inhibitors (21 studies), and CCBs (6 studies) more efficaciously (P < 0.001) reduced both central and peripheral SBP by a weighted mean difference of −5.63 (−6.50 to −4.76 mmHg) and −1.97 mmHg (−2.99 to −0.95 mmHg), respectively. Compared with older agents, the newer agents also more efficaciously (P < 0.001) reduced central PP (−3.27 mmHg; −4.95 to −1.59 mmHg), augmentation index (−6.11%; −7.94 to −4.29) and augmentation (−3.35 mmHg; −5.28 to –1.42 mmHg) but not peripheral PP (p ≥ 0.09). Accordingly, the newer agents reduced central-to-peripheral PP amplification significantly less than the older agents (0.11 mmHg; 0.05 to 0.17 mmHg; P < 0.001).Conclusion: Newer agents, such as RAS inhibitors and CCBs, were significantly more efficacious than older agents in their effects on central hemodynamics.

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Section: Resultsmentioning

confidence: 99%

Antihypertensive Treatment and Central Arterial Hemodynamics: A Meta-Analysis of Randomized Controlled Trials

Cheng

Xia

et al. 2021

Front. Physiol.

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“…CAVI may indicate the differential effects of various types of CCBs on arterial stiffness. Recent studies also report that novel antihypertensive agents, mineralocorticoid receptor blocker and direct renin inhibitor, also lower CAVI [51][52][53] .…”

Section: (E) Sleep Apnea Syndromementioning

confidence: 97%

New Horizons of Arterial Stiffness Developed Using Cardio-Ankle Vascular Index (CAVI)

Saiki

Ohira

Yamaguchi

et al. 2020

JAT

105

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Arterial stiffness is recognized mainly as an indicator of arteriosclerosis and a predictor of cardiovascular events. Cardio-ankle vascular index (CAVI), which reflects arterial stiffness from the origin of the aorta to the ankle, was developed in 2004. An important feature of this index is the independency from blood pressure at the time of measurement. A large volume of clinical evidence obtained using CAVI has been reported. CAVI is high in patients with various atherosclerotic diseases including coronary artery disease and chronic kidney disease. Most coronary risk factors increase CAVI and their improvement reduces CAVI. Many prospective studies have investigated the association between CAVI and future cardiovascular disease (CVD), and proposed CAVI of 9 as the optimal cutoff value for predicting CVD. Research also shows that CAVI reflects afterload and left ventricular diastolic dysfunction in patients with heart failure. Furthermore, relatively acute changes in CAVI are observed under various pathophysiological conditions including mental stress, septic shock and congestive heart failure, and in pharmacological studies. CAVI seems to reflect not only structural stiffness but also functional stiffness involved in acute vascular functions. In 2016, Spronck and colleagues proposed a variant index CAVI0, and claimed that CAVI0 was truly independent of blood pressure while CAVI was not. This argument was settled, and the independence of CAVI from blood pressure was reaffirmed. In this review, we summarize the recently accumulated evidence of CAVI, focusing on the proposed cutoff values for CVD events, and suggest the development of new horizons of vascular function index using CAVI. appropriate in studies that examine the effect of hypertension or the effect of antihypertensive drugs on intrinsic arterial stiffness. To overcome this problem, Hayashi 4) proposed the stiffness parameter , an index reflecting arterial stiffness of local arterial segment, which is not influenced by blood pressure at the time of measurement. Subsequently, this theory has been applied to a new arterial stiffness index called cardio-ankle vascular index (CAVI) developed in 2004 5) , and this index reflects the stiffness of the arterial tree from the origin of the aorta to the ankle. The CAVI equation was essentially derived from the stiffness parameter , and the changes of the artery caliber in the equation during the cardiac cycle were obtained Copyright©2020 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

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“…Many studies have reported that CAVI is high in people with hypertension [ 56 , 57 ]. Calcium channel blockers [ 58 , 59 ] and renin-angiotensin-aldosterone system inhibitors, including angiotensin receptor blockers [60][61][62] , angiotensin-converting enzyme inhibitors [63] , mineralocorticoid receptor blockers [64] , and direct renin inhibitors [65] , can improve CAVI. The reduction in arterial stiffness in response to antihypertensive treatment can be related to blood pressure lowering, but additional blood pressure-independent effects may also be involved.…”

Section: Antihypertensive Medicationsmentioning

confidence: 99%

Arterial stiffness in health and disease: The role of cardio–ankle vascular index

Miyoshi

Ito

2021

Journal of Cardiology

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Arterial stiffness increases with age, as well as in various pathological states, including obesity, diabetes mellitus, smoking, and dyslipidemia, and it has important consequences for cardiovascular health. Arterial stiffness plays a central role in hemodynamic dysfunction characterized by excess pulsatility; specifically, it leads to heart failure, cerebrovascular disease, and renal failure. Among measures of arterial stiffness, carotid-femoral pulse wave velocity is considered as the reference standard; however, it has not been incorporated into routine clinical practice. Cardio-ankle vascular index (CAVI), which is a marker of arterial stiffness measured from the origin of the aorta to the ankle, was developed in 2004. CAVI is based on stiffness parameter β, which is theoretically independent of blood pressure at the time of measurement. CAVI applies stiffness parameter β to arterial segments between the heart and ankle. The measurement of CAVI is simple and well-standardized, and its reproducibility and accuracy are acceptable. Several studies have demonstrated that CAVI is high in patients with various atherosclerotic risk factors, and treatment of cardiovascular risk factors and lifestyle modifications improve CAVI. Several prospective studies have investigated the association between CAVI and future cardiovascular events in the general population and in patients with cardiovascular risk factors. A cut-off value of 9.0 is proposed for predicting patients at a high risk of cardiovascular events. From this review, it is clear that CAVI may be useful in the prevention of cardiovascular disease.

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Comparable effect of aliskiren or a diuretic added on an angiotensin II receptor blocker on augmentation index in hypertension: a multicentre, prospective, randomised study

Cited by 7 publications

References 24 publications

Antihypertensive Treatment and Central Arterial Hemodynamics: A Meta-Analysis of Randomized Controlled Trials

Antihypertensive Treatment and Central Arterial Hemodynamics: A Meta-Analysis of Randomized Controlled Trials

New Horizons of Arterial Stiffness Developed Using Cardio-Ankle Vascular Index (CAVI)

Arterial stiffness in health and disease: The role of cardio–ankle vascular index

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