Antihypertensive treatment decreases arterial stiffness at night but not during the day. Results from the Hypertension in the Very Elderly Trial

The main Hypertension in the Very Elderly Trial (HYVET) demonstrated a very marked reduction in cardiovascular events by treating hypertensive participants 80 years or older with a low dose, sustained release prescription of indapamide (indapamide SR, 1.5 mg) to which was added a low dose of an angi...

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Bibliographic Details
Published in:Blood pressure 2017-04, Vol.26 (2), p.109-114
Main Authors: Bulpitt, Christopher J., Webb, Richard, Beckett, Nigel, Peters, Ruth, Cheek, Elizabeth, Anderson, Craig, Antikainen, Riitta, Staessen, Jan A., Rajkumar, Chakravarthi
Format: Article
Language:English
Subjects:
ambulatory blood pressure
Angiotensin-Converting Enzyme Inhibitors - administration & dosage
Antihypertensive Agents - administration & dosage
arterial compliance
Blood Pressure - drug effects
Blood Pressure Monitoring, Ambulatory
Hypertension - drug therapy
Hypertension - physiopathology
Hypertension in the very elderly
HYVET
Indapamide - administration & dosage
QKD
vascular stiffness
Vascular Stiffness - drug effects
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Summary:The main Hypertension in the Very Elderly Trial (HYVET) demonstrated a very marked reduction in cardiovascular events by treating hypertensive participants 80 years or older with a low dose, sustained release prescription of indapamide (indapamide SR, 1.5 mg) to which was added a low dose of an angiotensin converting enzyme inhibitor in two-thirds of cases (perindopril 2-4 mg). This report from the ambulatory blood pressure sub-study investigates whether changes in arterial stiffness and ambulatory blood pressure (BP) could both explain the benefits observed in the main trial. A total of 139 participants were randomized to placebo [67] and to active treatment [72] and had both day and night observations of BP and arterial stiffness as determined from the Q wave Korotkoff diastolic (QKD) interval. The QKD interval was 5.6 ms longer (p = 0.017) in the actively treated group at night than in the placebo group. This was not true for the more numerous daytime readings so that 24-h results were similar in the two groups. The QKD interval remained longer at night in the actively treated group even when adjusted for systolic pressure, heart rate and height. The reduced arterial stiffness at night may partly explain the marked benefits observed in the main trial.
ISSN:0803-7051
1651-1999
DOI:10.1080/08037051.2016.1219222