11. The Effect of Long-Term Administration of Hydrochlorothiazide on Central Blood Pressure

Abstract

Background

It’s unknown wheather there is much benefit on central aortic pressure than brachial pressure while long-term administration of hydrochlorothiazide in patients with essential hypertension.

Methods

The retrograde analysis was conducted at three of the participating centers in the Felodipine Event Reduction (FEVER) study. 76 of 129 patients in placebo group, who kept hydrochlorothiazide monotherapy over 36 months period, and took pulse wave recording at randomization, 12 month, 24 month and 36 month, were included into the final analysis. Radial artery pressure waveforms were measured with applanation tonometry, and convolved into the ascending aortic pressure waveforms, using the FDA-approved SphygmoCor system. The analysed parameters in aortic pressure waveform included first peak pressure, secondary peak pressure, diastolic pressure, pulse pressure, augmentation and augmentation index.

Results

In comparison with baseline, there were substantial falls (P < 0.001) in brachial SP/DP and in central aortic SP/DP with no difference, slight falls (P < 0.05) in aortic augmentation, and no significant falls (P > 0.05) in augmentation index and heart rate.

Conclusion

Long-term administration of hydrochlorothiazide resulted in the similar reduction of both brachial pressure and central aortic pressure without the change of augmentation index, which could exclude definite benefit on central aortic pressure than brachial pressure.