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26 Pressure‐independent improvement in aortic distensibility in hypertensives undergoing haemodialysis

Background: Hypertensive patients undergoing haemodialysis have a markedly impaired large artery distensibility and an increased cardiovascular morbidity. Method: We investigated 12 such patients (eight men and four women; age±SD, 53±12 years) following a single dose of an angiotensin converting enzyme (ACE) inhibitor (quinapril, 20 mg) or placebo in a randomized cross-over study for 1 week. We measured repeatedly blood pressure and aortic distensibility (carotid-femoral puke wave velocity). Repeated-measure one-way analysis of variance and repeated-measure analysis of covariance were performed because of the tight link between pressure and arterial function. Results: Blood pressure decreased (systolic arterial pressure, P<0.01; diastolic arterial pressure, P<0.001) and pulse wave velocity significantly improved independently of the pressure decrease. Conclusion: The ACE inhibitor quinapril reduces blood pressure in hypertensive patients undergoing haemodialysis and improves large arterial function independently of blood pressure changes.