The Effect of Perindopril and Amlodipine on Brachial Artery Pulse Wave Velocities in Patients With Essential Hypertension

Abstract

It is known that the brachial artery flow velocity as assessed by duplex Doppler ultrasound is changed in hypertension. The main purpose of this study was to assess the effects of perindopril and amlodipine on the brachial artery pulse wave velocity in essential hypertension. Blood flow profile and velocity of the brachial artery were determined noninvasively by pulsed Doppler ultrasound technique under the guidance of a B-mode ultrasound image. Thirty-two untreated hypertensive patients and 11 control subjects matched for age and sex were included in the study. Hypertensive patients were classified into two groups which were treated either with amlodipine 5 mg or perindopril 4 mg and re-evaluated after 15 days. Patients with essential hypertension had significantly larger peak systolic velocity than those without it (71(18 cm/sec vs. 45(16 cm/sec, P<0.001). After antihypertensive treatment, significant decrease was found in the mean blood pressures of both groups (P<0.001). After treatment with perindopril, peak systolic velocity decreased (73±19 vs 58±14 cm/sec, P<0.05) and duration of systolic flow prolonged (269±18ms vs 291±17ms, P<0.05). Also, after treatment with amlodipine, peak systolic wave decreased (68±15ms vs 55±13ms, P<0.05) and duration of systolic flow prolonged (266±17ms vs 288±18ms, P<0.01). In conclusion, as assessed by duplex Doppler ultrasound, peak systolic wave was increased and systolic flow duration not changed in essential hypertension. Both perindopril and amlodipine treatments decreased peak systolic velocity and prolonged systolic flow duration. Further study is needed to clarify the exact mechanisms of the flow velocity alterations with antihypertensive therapy.