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J Korean Soc Hypertens. 2014 Mar;20(1):21-30. Korean.
Published online March 31, 2014.  https://doi.org/10.5646/jksh.2014.20.1.21
Copyright © 2014. The Korean Society of Hypertension
Effects of Valsartan on Carotid Arterial Stiffness in Patients with Newly Diagnosed Hypertension: A Comparative Study with Global Arterial Stiffness
Yi Rang Yim, MD, Kye Hun Kim, MD, Jae Yeong Cho, MD, Hyun Ju Yoon, MD, Young Joon Hong, MD, Hyung Wook Park, MD, Ju Han Kim, MD, Youngkeun Ahn, MD, Myung Ho Jeong, MD, Jeong Gwan Cho, MD and Jong Chun Park, MD
Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.

Corresponding author (Email: christiankyehun@hanmail.net )
Received January 27, 2014; Revised March 17, 2014; Accepted March 17, 2014.

Abstract

Background

To compare the parameters of local carotid stiffness with those of global arterial stiffness and to investigate the effects of angiotensin II receptor blocker (ARB) on the parameters of local carotid arterial stiffness as well as global arterial stiffness.

Methods

The correlations of the parameters between local carotid and global arterial stiffness were compared at baseline, and the changes of these parameters were evaluated after 6 months of valsartan therapy in 50 patients with newly diagnosed hypertension. Diameter change, strain, and 2-dimensional circumferential strain (2D CS) of the carotid artery measured by speckle tracking method were used as parameters of local arterial stiffness, and the parameters of pulse wave velocity (PWV) and pulse wave analysis (PWA) were used as standard parameters of global arterial stiffness.

Results

Carotid 2D CS, not conventional strain or diameter change, showed significant correlation with age (r = -0.592, p < 0.01), brachial-ankle PWV (r = -0.338, p < 0.05), and augmentation index (r = -0.298, p < 0.05). After 6 months of medical therapy, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were decreased significantly (SBP: 155.9 ± 14.2 to 137.6 ± 10.5 mm Hg, p < 0.01; DBP: 90.1 ± 11.8 to 81.6 ± 8.0 mm Hg, p < 0.01). The parameters of PWV and PWA were significantly improved, but the parameters of carotid arterial stiffness were not changed significantly.

Conclusions

In hypertensives, carotid 2D CS showed better correlation with ageing and the parameters of global arterial stiffness than conventional strain or diameter change of the carotid artery. Global arterial stiffness was improved by 6 months of medical treatment with ARB, but the local carotid arterial stiffness was not changed.

Keywords: Vascular stiffness; Hypertension; Angiotensin receptor antagonists

Figures


 Fig. 1
Measurement of 2-dimensional (2D) circumferential strain (CS) of the carotid artery by speckle tracking method. (A) Higher value of 2D CS in a young hypertensive and (B) lower value of 2D CS in an older hypertensive were shown.
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Fig. 2
Correlations of carotid strain and 2-dimensional circumferential strain (2D CS) with aging.
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Fig. 3
Correlation of carotid 2-dimensional circumferential strain (2D CS) with brachial-ankle pulse wave velocity (BAPWV) and augmentation index (AI).
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Tables


 Table 1
Baseline characteristics of the study subjects (n = 50)
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Table 2
Ultrasound findings of the carotid arteries
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Table 3
Correlations among the parameters of arterial stiffness
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Table 4
Changes of blood pressure and the parameters of arterial stiffness
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Notes

No potential conflict of interest relevant to this article was reported.

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