Gender specific differences in the effects of antihypertensive therapy on arterial hemodynamic, arterial wall stiffness and structure-functional condition of the heart in patients over 65 years old with uncomplicated arterial hypertension

Abstract

Gender specific differences in the effects of antihypertensive therapy on arterial hemodynamic, arterial wall stiffness and structure-functional condition of the heart in patients over 65 years old with uncomplicated arterial hypertension Abstract. In this research we have investigated in 65 years old non-diabetic patients with uncomplicated arterial hypertension, the influence of two types of antihypertensive treatment based on a renin-angiotensin system inhibitor (RAS) and a dihydropyridine calcium channel blocker (CCB) ± thiazide-like diuretic (indapamide) on central and brachial blood pressure (BP) hemodynamics and in several cardiac and vascular structure-function parameters. We included 174 patients from two centers (83 males and 91 females). After 6 months a total of 158 patients finished the study. We found that amlodipine + indapamide therapy was more effective than RAS inhibitors + indapamide in reducing brachial and central systolic BP, and central pulse pressure in males. In addition, and regardless of gender, the calcium channel blocker therapy achieve a greater reduction on left ventricle pulsatile load (measured by augmentation markers), on arterial stiffness (measured by carotid-femoral pulse wave velocity) and regression of LV hypertrophy. Therapy with amlodipine plus indapamide was associated with an increase in heart rate. Summary. Amlodipine plus indapamide is more effective than indapamide with RAS inhibitor to improve several target organ damage in mild-moderate hypertensive patients.