The effects of antihypertensive therapy on carotid vascular structure in man

doi:10.1016/S0008-6363(95)00026-7

Cardiovascular Research 1995 30(1):147-152; doi:10.1016/S0008-6363(95)00026-7
© 1995 by European Society of Cardiology

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The effects of antihypertensive therapy on carotid vascular structure in man

Jamil Mayet^{a, c}^*, Alice V. Stanton^a, Anne-Marie Sinclair^a, Judy MacKay^a, Manjit Shahi^c, Rodney A. Foale^c, Andrew Nicolaides^d, Neil R. Poulter^a, Peter S. Sever^a, Simon A.McG. Thom^a and Alun D. Hughes^b

^aThe Peart-Rose Clinic, St. Mary's Hospital Medical School, Imperial College of Science, Technology and Medicine, London, UK
^bDepartment of Clinical Pharmacology, St. Mary's Hospital Medical School, Imperial College of Science, Technology and Medicine, London, UK
^cDepartment of Cardiology, St. Mary 's Hospital Medical School, Imperial College of Science, Technology and Medicine, London, UK
^dDepartment of Vascular Surgery, St. Mary 's Hospital Medical School, Imperial College of Science Technology and Medicine, London, UK

^* Corresponding author. Department of Clinical Pharmacology, 10th Floor QEQM Wing, St. Mary's Hospital Medical School, Praed Street, Paddington, London W2 1NY, UK. Tel/Fax (+44-71) 725-1117/(+44-71) 725-6145.

Objective: An increased carotid ultima-media thickness (IMT)has been found to be associated with a number of cardiovascularrisk factors such as age, hypertension, cigarette smoking, hypercholesterolaemiaand left ventricular hypertrophy. Our objective was to assesswhether carotid intima-media thickness in hypertensive patientscould be reduced by antihypertensive therapy. Methods: 13 hypertensivepatients, 10 previously untreated, were examined using carotidultrasonography and echocardiography at baseline and then at8 weeks and 39 weeks after commencement of antihypertensivetherapy with ramipril and the second-line addition of felodipine.Results: By the end of the study significant regression of IMT(0.1(0.05–0.16) mm, F-value 10.2, P < 0.01) and leftventricular mass index had occurred (25(10.7–39.3) g/m²,F-value 9.7, P < 0.01). The reduction in IMT was significantlyrelated to the reduction in mean arterial pressure, r = 0.55,P = 0.05). Conclusion: Antihypertensive therapy with ramipriland felodipine causes regression of IMT in hypertensive patients,probably chiefly through blood pressure reduction. Large prospectivestudies are required to assess whether a reduction in IMT resultsin a reduction in morbidity and mortality.

KEYWORDS Hypertension; Human, arteries; Ultrasound; Vascular structure; Calcium antagonists; ACE inhibitors

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