Differential pulse pressure response to various antihypertensive drug families

Pulse pressure ( PP) is emerging as a major pressure predictor of cardiac disease. The study comprised 10 185 untreated patients with essential hypertension. A total of 5395 men and 4790 women 56 +/- 13 years old, with uncomplicated essential hypertension, after a 15-day washout period and after 6 months of antihypertensive monotherapy were included. All patients included in the final cohort were responders and had normalized their blood pressure. PP was decreased least with diuretics ( - 5 mm Hg) and most with angiotensin II receptor blockers (ARBs) and calcium antagonists ( = 15 mm Hg), followed by angiotensin-converting enzyme inhibitors (ACEI) ( - 12mm Hg) alpha- and beta-blockers ( - 10 and -9 mm Hg), differentiating among antihypertensive classes ( P<0.001). The magnitude of PP fall was related to the degree of left ventricular (LV) mass reduction (P<0.001), seen best with ARBs ( r = 0.42) and least with ACEIs ( r = 0.18). Of the antihypertensive medications used in everyday practice, PP decrease may be achieved best with ARBs and calcium antagonists, whereas diuretics confer poor response. PP was decreased least with diuretics ( - 5 mm Hg) and most with ARBs and calcium channel blockers ( - 15 mm Hg), followed by ACEI ( - 12 mm Hg) alpha- and beta-blockers ( - 10 and - 9 mm Hg), differentiating among antihypertensive classes ( P<0.001). Of the antihypertensive medications used in everyday practice, PP decrease may be achieved best with ARBs and calcium antagonists.