Effect of Antihypertensive Therapy on Aortic Distensibility in Patients with Essential Hypertension: Comparison with Trichlormethiazide, Nicardipine and Alacepril

To assess the effect of antihypertensive drugs on aortic distensibility, we evaluated the aortic distensibility of 33 hypertensive patients before and after antihypertensive treatment by using cine magnetic resonance imaging. Thirty three hypertensive patients were divided into three groups and treated for 12 weeks with 2–4 mg trichlormethiazide per day (n = 10), 80 mg nicardipine per day (n = 13) and 50 mg alacepril per day (n = 10). There were no significant differences in mean age and mean blood pressure among the three groups. Cine magnetic resonance was performed at ascending and descending aortic levels. Aortic area was measured at the maximum and minimum frames. The effect of antihypertensive therapy on aortic distensibility was evaluated as the percent change from before treatment to after treatment. There were no significant differences in pulse pressure before and after treatment with trichlormethiazide, nicardipine and alacepril. After treatment with these drugs, mean blood pressure in all groups decreased (trichlormethiazide and nicardipine, P < .01; alacepril, P < .05), (the maximum area - the minimum area) and aortic distensibility in all groups increased significantly (each P < .01). Percent changes in aortic distensibility after treatment were significantly higher with nicardipine (ascending, 346.6 ± 255.9%; descending, 338.8 ± 246.5%, each P < .05) and alacepril (ascending, 369.7 ± 238.8%, P < .05; descending, 306.9 ± 123.3%, P < .01) than with trichlormethiazide (ascending, 146.0 ± 139.6%; descending, 129.3 ± 97.5%). In conclusion, nicardipine and alacepril have a beneficial effect on aortic distensibility.