Effects of Angiotensin-Converting Enzyme Inhibitors on Arterial Stiffness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Li, Xiuli; Chang, Peng; Wang, Qiongying; Hu, Hao; Feng, Bo; Li, Ningyin; Yu, Jing

doi:10.1155/2020/7056184

Cited by 20 publications

(13 citation statements)

References 56 publications

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“…Our results confirm the hypothesis that non-dipping status combined with PreD would lead to even greater PWV values, especially in subjects with uncontrolled arterial hypertension (group C), increasing their CV risk to high or very high [ 45 ]. We assume that PreD and non-dipper status did not affect PWV values in group B as expected (as in groups A and C) because of antihypertensive medication’s protective effect on the CV system (e.g., ACE inhibitors, ARBs) and good BP regulation [ 46 ].…”

Section: Discussionmentioning

confidence: 94%

Prediabetes, Non-Dipping Profile and Hypertension—A Recipe for Increased Arterial Stiffness

et al. 2023

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Background: Pulse wave velocity (PWV) is a known predictor of target organ damage, cardiovascular disease and overall mortality. The aim of this study was to compare the PWV values in subjects with prediabetes, a non-dipper profile and arterial hypertension with their values in healthy subjects. Methods: A total of 301 subjects, aged 40–70 years, without diabetes mellitus were included in this cross-sectional study (150 with prediabetes). They underwent a 24 h ambulatory blood pressure monitoring (ABPM). Subjects were divided into three hypertension groups (A = healthy, B = controlled hypertension, C = uncontrolled hypertension). Dipping status was determined according to ABPM results, and PWV was measured by an oscillometric device. Prediabetes was defined as having 2 separate fasting plasma glucose (FPG) measurements between 5.6 and 6.9 mmol/L. Results: The highest PWV values were found in group C (9.60 ± 1.34 vs. 8.46 ± 1.01 in group B vs. 7.79 ± 1.10 in group A; p < 0.001), in subjects with prediabetes (8.98 ± 1.31 m/s vs. 8.26 ± 1.22 m/s; p < 0.001) and in prediabetic non-dippers among age groups (p = 0.05). In the multivariate regression model age, blood pressure, nocturnal indices and FPG were shown as independent predictors of PWV values. Conclusion: Significantly higher PWV values were found in subjects with prediabetes and non-dipping profiles in all three examined hypertension groups.

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Section: Discussionmentioning

confidence: 94%

Prediabetes, Non-Dipping Profile and Hypertension—A Recipe for Increased Arterial Stiffness

et al. 2023

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“…Unfortunately, owing to the unavailability of participants’ individual data, we were unable to perform subgroup analyses according to background treatment in subjects treated with SGLT-2 inhibitors. As we know, drug classes, such as renin-angiotensin-aldosterone system blockers, 38–40 b-blockers, 41 and statins 42 exert beneficial effects on aortic stiffness. Future trials will determine whether the combination of SGLT-2 inhibitors with such drug classes provides a greater reduction in PWV.…”

Section: Discussionmentioning

confidence: 99%

Effect of sodium-glucose co-transporter-2 inhibitors on arterial stiffness: A systematic review and meta-analysis of randomized controlled trials

et al. 2022

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Background: Arterial stiffness represents an established cardiovascular risk marker. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have significant cardio-protective effects. Herein we sought to determine the effect of SGLT-2 inhibitors on pulse wave velocity (PWV). Methods: We searched PubMed, Cochrane Library, and grey literature from inception to 7th February 2022 for randomized controlled trials (RCTs) enrolling adult subjects with or without type 2 diabetes mellitus (T2DM), assigned to a SGLT-2 inhibitor versus control and addressing their effect on PWV. We set as primary efficacy outcome the change in PWV with SGLT-2 inhibitors versus placebo or control. Results: We pooled data from six trials in a total of 452 enrolled participants assigned either to SGLT-2 inhibitor or control. Overall, SGLT-2 inhibitor treatment compared to control resulted in a nonsignificant decrease in PWV. Exclusion of a trial utilizing cardiac magnetic resonance imaging for the assessment of PWV demonstrated that SGLT-2 inhibitors induce a significant reduction in PWV by 0.21 m/s. When we restricted our analysis to RCTs enrolling subjects with T2DM, we observed that SGLT-2 inhibitor compared to control resulted in a significant decrease in PWV by 0.17 m/s. Conclusion: SGLT-2 inhibitors do not decrease PWV in patients with established cardiovascular disease or cardiovascular risk factors. However, we have shown that SGLT-2 inhibitors lead to a slight, but significant decrease in PWV in patients with T2DM. The latter finding is of great value, based on the significant correlation between PWV and micro- and macro-vascular complications of T2DM.

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“…Virtually, all classes of antihypertensive medication have been subjected to trials evaluating their effects on LAS, and Table 3 summarizes their relative effectiveness on LAS. For example, angiotensin-converting enzyme inhibitors are as effective as other antihypertensive classes in reducing PWV and better than placebo [46]. The magnitude of effect on LAS does appear to differ among the various classes of antihypertensive agents, and these differences underlie the purpose of the Strategy for Preventing cardiovascular and renal Events based on AR-TErial stiffness (SPARTE) [47] wherein a destiffening strategy of preference for agents which block the renin system used at maximal tolerated dosages, in addition to an emphasis on dietary and exercise encouragement, is being compared with standard European Guidelines for hypertension treatment at hypertension centers in France.…”

Section: Pharmacologic Therapies Statinsmentioning

confidence: 99%

Large Artery Stiffness: A Companion to the 2015 AHA Science Statement on Arterial Stiffness

Rey-García¹,

Townsend²

2021

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Large artery stiffness (LAS) has proven to be an independent risk factor for cardiovascular disease and mortality. Nevertheless, the position of current hypertension guidelines regarding the usefulness of assessing LAS differs across different continents. In general, European Guidelines recognize pulse wave velocity (PWV) as a marker of target organ damage but do not recommend its systematic use in general population. Asian guidelines consider PWV as a recommended test at diagnosis of hypertension, in contrast to North American guidelines that do not state any position about its usefulness. However, PWV predicts cardiovascular events, and several studies have shown that it improves risk classification adjusting for established risk factors especially for intermediate-risk patients. Finally, some advances have been made related to treatments affecting LAS. Dietary interventions such as sodium restriction and exercise-based interventions have a modest effect in reducing LAS. Pharmacological interventions, such as statins, or more recent advances with mineralocorticoid blocker seem to have a beneficial effect. Last, controversial effects of renal denervation on LAS have been found. Our goal here is to update the reader on LAS on these areas since the 2015 American Heart Association Scientific Statement.

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Effects of Angiotensin-Converting Enzyme Inhibitors on Arterial Stiffness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cited by 20 publications

References 56 publications

Prediabetes, Non-Dipping Profile and Hypertension—A Recipe for Increased Arterial Stiffness

Prediabetes, Non-Dipping Profile and Hypertension—A Recipe for Increased Arterial Stiffness

Effect of sodium-glucose co-transporter-2 inhibitors on arterial stiffness: A systematic review and meta-analysis of randomized controlled trials

Large Artery Stiffness: A Companion to the 2015 AHA Science Statement on Arterial Stiffness

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