24-hour arterial stiffness monitoring in assessment of antihypertensive therapy efficacy

Objective. To assess the possibilities of 24-hour arterial stiffness monitoring in evaluation of antihypertensive treatment efficacy. Design and methods. We performed an open, cross-sectional, randomized trial in 32 patients with stable arterial hypertension (mean age 55 ± 0,2 years) treated consequently by enalapril (E) 5-20 mg/day and metoprolol (M) 100-200 mg/day. 24-hour blood pressure and arterial stiffness monitoring (BPLab) was performed 4 times: initially, at the end of treating by each of the drugs and in «wash-out» periods between different treatment. The following parameters were assessed: pulse wave velocity (2 ways of evaluation - PTT1 and PTT2); augmentation index (AIX), arterial stiffness index (ASI), maximal blood pressure gradient ([dP/dt]max). Results. Both drugs had an antihypertensive effect (- 20,5 ± 1,6/11,6 ± 1,3 mmHg at M treatment and -18,4 ± 1,6/12,3 ± 1,2 mmHg at E therapy, p < 0,05). Significant spontaneous changes of arterial stiffness and 24-hour parameters PTT1 and PTT2 were not found. However, 24-hout AIX significantly improved at both therapy schemes (in M treatment from -7,6 ± 2,7 to -14,0 ± 2,8 %, and in E treatment to 15,0 ± 2,7 %). ASI and dP/dtmax significantly decreased. Conclusions. According to our data, 24-hour arterial stiffness monitoring presents additional important data on antihypertensive efficacy of the treatment. Our results on arterial stiffness changes under therapy by angiotensin-converting enzyme inhibitor and beta-adrenoblocker differ from the current view on their effects. This can be due to the 24-hour monitoring of the parameters that we used in our study.

arterial stiffness, pulse wave velocity, oscillometric method, 24-hour monitoring

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