The Effect of Antihypertensive Drugs on Arterial Stiffness and Central Hemodynamics: Not All Fingers are Made the Same

摘要

Arterial stiffness and central hemodynamics attract increasing scientific interest within the hypertensive communityduring the last decade. Accumulating evidence indicates that aortic stiffness is a strong and independent predictorof cardiovascular events and all-cause mortality in hypertensive patients, and its predictive value extends beyond traditionalrisk factors. The role of central hemodynamics and augmentation index (a marker of reflected waves), remains lessestablished and requires further investigation. Several lines of evidence indicate that antihypertensive therapy results insignificant reductions of pulse wave velocity and central hemodynamics. However, beta-blockers seem to be the only exceptionwith significant within-class differences. Conventional beta-blockers, although equally effective in reducing pulsewave velocity, seem to be less beneficial on central hemodynamics and augmentation index than the other antihypertensivedrug categories, whereas the newer vasodilating beta-blockers seem to share the benefits of the other antihypertensivedrugs. In conclusion, aortic stiffness seems ready for ‘prime-time’ in the management of essential hypertension, while furtherresearch is needed for central hemodynamics and augmentation index.