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Abstract P474: Comparison of the Effect of Different Calcium Channel Antagonists on Arterial Stiffness and Central Pressures in Moderate Hypertensive Patients Receiving Enalapril as First Line Treatment


 Introduction:
 ACE inhibitors reduce blood pressure (BP)satisfactorily, with enalapril (ENL) being one of the most used in daily clinical practice. However, little is known about its effects on arterial stiffness (AS) and central BP when associated with calcium-antagonists (CCA). So we studied three CCA associated with ACE inhibitors.
 
 
 Objectives:
 To evaluate the effects of three CCA: amlodipine (AML), nifedipine ( NFD)and barnidipine (BND) associated with ENL, on AS, central systolic and diastolic BP: (SBPc, DBPc),diastolic heart function in moderate hypertensive patients (Phta).
 
 
 Material and Methods:
 We studied 156 Phta males (68 ± 6 years old) who were treated by their primary care physician with ENL and AML,NFD OR BND. They were grouped into three groups: Group I: 53 Phta receiving ENL +AML, Group II: 50 Phta receiving ENL+ NFD and 53 Phta treated with ENL + BND to maintain BP under 140/90 mmHg. In all, an echocardiogram was performed to measure the Left ventricular mass index (LVMI), the E / A mitral flow index . We measured with 24-hour ABPM , AS by augmentation index (AI)and pulse wave velocity (PWV), and,central BP. The results were compared and presented in Tables I:
 
 
 
 
 * =p value ≤0.05
 
 CONCLUSIONS:
 according to our data, it is preferable to use AML as a CCA,because it not only reduces BP better but also the central BP, improving AS in small and large vessels. The BND would be the other choice, since it does not present significant differences with respect to the first group. NFD , in addition to, not demonstrating superiority, also does not reduce DBPc in these Phta. Therefore, we consider that the presented data have sufficient clinical relevance to choose CCA associated with an ACE inhibitor.
