Efficacy of Various Antihypertensive Agents as Evaluated by Indices of Vascular Stiffness in Elderly Hypertensive Patients

Takami, Takeshi; Shigemasa, Minori

doi:10.1291/hypres.26.609

Cited by 83 publications

(57 citation statements)

References 30 publications

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“…Second, it has been reported that antihypertensive drugs decrease baPWV, and the degree of the decrease varies according to the class of antihypertensive drug. 29 Although in our study the presence or absence of on medication use was self-reported and confirmed by a physician, on the classes of antihypertensive drugs was not confirmed. A study of a population including a larger number of subjects taking distinct classes of antihypertensive drugs is necessary.…”

Section: Discussioncontrasting

confidence: 60%

Association between brachial–ankle pulse wave velocity and 3-year mortality in community-dwelling older adults

et al. 2010

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With aging, arterial stiffness increases and results in cardiovascular diseases. Recently, high brachial-ankle pulse wave velocity (baPWV), measured using a new noninvasive device to estimate arterial stiffness, was reported to be associated with the prevalence of cardiovascular diseases. The purpose of this study was to clarify the association between baPWV with 3-year mortality in community-dwelling older adults and to determine the cutoff value of baPWV in terms of mortality. A total of 530 subjects aged 65 years or older (men/women, 207:323; mean age, 76 years) participated. They were dichotomized by the median value of baPWV. Within 3 years, 30 deaths occurred, including 11 cardiovascular deaths. The high-baPWV group had a higher incidence of total deaths (high-baPWV group vs. low-baPWV group, 8.3 vs. 3.0%, respectively) and cardiovascular deaths (high-baPWV group vs. lowbaPWV group, 3.8 vs. 0.4%, respectively). A high-baPWV level was associated with an increased risk of 3-year total mortality after adjustment for age, sex and systolic blood pressure (hazard ratio for high baPWV vs. low baPWV¼2.98, 95% CI¼1.25-7.07) and with an increased risk of 3-year cardiovascular mortality (hazard ratio for high baPWV vs. low baPWV¼10.01, 95% CI¼1.21-82.49). A receiver-operating characteristic curve showed that the optimal cutoff value of baPWV for total mortality was 19.63 m s À1 , and for cardiovascular mortality it was 19.63 m s À1 . This study provides a preliminary finding that assessment of arterial stiffness by baPWV might be a useful method to predict mortality risk in community-dwelling older adults. Large longitudinal studies for extended periods of time are necessary to confirm the association.

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Section: Discussioncontrasting

confidence: 60%

Association between brachial–ankle pulse wave velocity and 3-year mortality in community-dwelling older adults

et al. 2010

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“…43 Furthermore, these classes of antihypertensive drugs have been shown to reduce arterial stiffness 44 and reserve cerebral blood flow, thus are thought to be suitable for patients with SVD. 45 These findings may suggest that the classes of antihypertensive drugs may influence on the development of SVD including MBs.…”

Section: Discussionmentioning

confidence: 99%

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

et al. 2009

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Silent cerebral microbleeds (MBs) are a common finding in stroke patients, especially those with intracerebral hemorrhage, and are thought to be a marker of future cerebral hemorrhage. Clinically, two distinct forms of MBs have been documented, those observed with either or both stroke or small vessel disease (SVD) and those associated with cerebral amyloid angiopathy. We investigated a possible association between MBs and arterial stiffness in a general population. Subjects were 443 apparently healthy individuals with a mean age of 67.1 ± 8.1 years. The presence of MBs, lacunar infarcts and periventricular hyperintensity (PVH) was determined by 3-tesla magnetic resonance imaging. Carotid intima-media thickness (IMT) was measured by ultrasonography. Arterial stiffness was evaluated by brachial-to-ankle pulse wave velocity (baPWV), and the Framingham stroke risk score (FSRS) was obtained as an integrated cerebrovascular risk factor. The prevalence of MBs was 5.0%. Both baPWV and FSRS were significantly higher in subjects with MBs (1820 ± 308 vs. 1645 ± 325 cm/s, P¼0.014 and 12.1 ± 8.6 vs. 8.9 ± 7.5%, P¼0.047, respectively). Odds ratio of a high baPWV, defined as X1500 cm/s, for the presence of MBs was 6.05 even after correction for confounding parameters, including age and hypertension. This association with high baPWV remained irrespective of MBs location, whether strictly located in the lobes or in the basal ganglia and infratentorial regions. These findings indicate an association between arterial stiffness and the presence of MBs. Assessment of arterial stiffness may be useful in identifying subjects at high risk for the presence of MBs.

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“…Four trials studied brachial-ankle PWV using four different CCBs (amlodipine, 19,26 nifedipine controlled release 26,30 or coat-core 28 or cilnidipine 30 ) in comparison with an ACE inhibitor (temocapril) 30 or ARBs (candesartan 26 or valsartan 19,28,30 ). Amlodipine was compared with valsartan in 100 untreated hypertensive patients (50 subjects per group) 19 and with candesartan in 16 hypertensive, diabetic patients (11 vs. 5 subjects).…”

Section: Protection Against Target Organ Damagementioning

confidence: 99%

Use of dihydropyridine calcium channel blockers in the management of hypertension in Eastern Asians: A scientific statement from the Asian Pacific Heart Association

et al. 2011

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Efficacy of Various Antihypertensive Agents as Evaluated by Indices of Vascular Stiffness in Elderly Hypertensive Patients

Cited by 83 publications

References 30 publications

Association between brachial–ankle pulse wave velocity and 3-year mortality in community-dwelling older adults

Association between brachial–ankle pulse wave velocity and 3-year mortality in community-dwelling older adults

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

Use of dihydropyridine calcium channel blockers in the management of hypertension in Eastern Asians: A scientific statement from the Asian Pacific Heart Association

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