P.071 Angiotensin Receptor Antagonism with Valsartan Decreases Arterial Stiffness in Hypertensive Patients with Metabolic Syndrome

Abstract

Background

Angiotensin II (AT II) plays a key role in the development of vascular disease. Arterial stiffness is an important, independent predictor of cardiovascular risk. We investigated the long-term effects of selective AT₁receptor blockade with valsartan on arterial stiffness in patients with hypertension and metabolic syndrome (MS).

Study design and Methods

We have examined 30 patients (16 males and 14 females, aged 47±1 years, BMI 29–46 kg/m²) with the MS and mild essential hypertension in the double blind, placebo controlled study. We measured brachial blood pressure (BD, mmHg), brachial-ankle pulse wave velocity (baPWV, cm/s) and the augmentation index (Aix, %) by using tonometry, volume-plethysmography and Doppler ultrasonography before and after 20 weeks of treatment with valsartan (40 to 160 mg/day). Statistical significance was assessed by t-test or two-way ANOVA of the dose responses curves.

Results

After 20 weeks of treatment with valsartan, baPWV and Aix were reduced: mean delta systolic BP 12±1.6 mmHg (P = 0.02 vs. baseline), diastolic BP 5.1±1.8 mmHg (P <0.0001 vs. baseline), mean BP 7.5±2.7 mmHg (P = 0.003 vs. baseline), baPWV 2.4±0.03 cm/s (P = 0.02 vs. baseline), Aix 23±8% (P = 0.002 vs. baseline). Delta baPWV was significantly higher in the group of female patients with the MS (F/M: 2.9±0.02 cm/s vs. 2.1±0.05 cm/s, P = 0.003).

Conclusion

AT₁receptor antagonism reduced the arterial stiffness in hypertensive patients with MS, and may provide new therapeutic strategies for cardiovascular risk reduction.