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NDT Advance Access published online on January 14, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfm936
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


A randomized, double-blind study of valsartan versus metoprolol on arterial distensibility and endothelial function in essential hypertension

Markus Kosch, Andrea Levers, Detlef Lang, Valerie Bartels, Karl Heinz Rahn, Hermann Pavenstädt and Martin Hausberg

Department of Internal Medicine D, University of Münster, 48129 Münster, Germany

Correspondence and offprint requests to: Markus Kosch, Department of Internal Medicine D, University of Münster, Albert-Schweitzer-Strasse 33, D-48149 Münster, Germany. Tel: +49-251-8347539; Fax: +49-251-8346979; E-mail: markuskosch{at}gmx.de



  Abstract

Background. Antihypertensive drugs may have differential, pressure-independent effects on hypertension-associated alterations of arterial function. We compared the effects of a 12-week therapy with the AT1-receptor antagonist valsartan (Val) versus the beta-blocker metoprolol (Met) on arterial stiffness and endothelial function in mildly hypertensive patients at rest and during generalized sympathetic stimulation.

Methods. Sixty-eight patients (37 male, 31 female, 46 ± 6 years) were randomized to Val (80–160 mg/d) or Met (50–100 mg/d). Effects of therapy on endothelial function, brachial and carotid artery distensibility coefficients, pulse wave velocity, carotid intima-media thickness and elastic modulus were assessed at rest and during the cold pressor test.

Results. Fifty-two patients were available for per protocol analysis. Blood pressure was comparably reduced in both treatment groups. Effects on endothelial function and large artery elastic wall properties did not differ significantly between the two antihypertensive treatment regimens. Trends did not differ significantly between groups for any parameter including carotid intima-media thickness and elastic modulus.

Conclusion. Short-term treatment with Val and Met had similar effects on large artery functional vessel wall properties in a population of mildly hypertensive patients.

Keywords: arterial distensibility and compliance; AT1-receptor blocker; endothelial function; essential hypertension; intima-media thickness

Received for publication: 24. 4.07
Accepted in revised form: 18.12.07


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