P1.04 The Influence of Quinapril on Arterial Stiffness, Blood Viscosity and Arterial Shear Stress in Patients with Essential Arterial Hypertension

Abstract

Aim

to analyze the influence of quinapril on aortic PWV, whole blood viscosity (WBV), shear stress in the ascending aorta (AA) and common carotid artery (CCA), prometaloproteinase-1 (proMMP-1) and its tissue inhibitor (TIMP-1) plasma concentration in patients with essential arterial hypertension (HT).

Methods

55 patients, (mean age 55,8 ± 13,8 yrs.) with HT 1 and 2 gr. were treated with quinapril in stepwise increased doses from 10 to 40 mg/d till BP goal <140/90 mmHg was achieved. At baseline and then after 3 and 6 months of treatment PWV, WBV, proMMP-1 and TIMP-1 were determined. Shear stress in AA and CCA was calculated from WBV, internal vessel diameter and blood flow velocity (Vmax) measured ultrasonographycally.

Results

After 6 months of treatment by quinapril we observed decrease of BP (155.6/92.0 mmHg vs. 135.9/82.9 mmHg, p<0.001), PWV (10.35 m/svs. 9.64 ms, p<0.001), WBV (5.14 cP vs. 4.86 cP, p<0.05) and TIMP-1 (111.0 ng/mlvs. 94.1 ng/ml, p<0.001) and increase of Vmax in AA (127.1 cm/svs.131.3 cm/s, p<0.05, Vmax in CCA (69.9cm/s vs. 78.4 cm/s, p<0.05) and shear stress in CCA (22.2 dyne/cm² vs. 24.7 dyne/cm² , p<0.05). Significant positive correlation was observed for PWV and TIMP-1, and negative correlations for PWV and Vmax in AA, PWV and Vmax in CCA, as well as PWV and shear stress in CCA.

Conclusions

Quinapril reduces arterial stiffness by inhibition of collagen metabolism. This effect is mediated by influence on arterial shear stress.