Antihypertensives affect BP differently

Different antihypertensives have different effects on central aortic BP, despite having the same effect on brachial BP, according to an analysis from the Scandinavian Cardiac Outcomes Trial (ASCOT).

This difference could account for the differing effects on cardiovascular risk of different classes of antihypertensives.

The researchers examined the impact of treatments based on the beta-blocker, atenolol, or the calcium-channel blocker, amlodipine, on brachial BP and central aortic pressure in 2,199 patients and found the two therapies produced similar reductions in brachial systolic pressure.

But amlodipine produced a five times greater reduction in central aortic systolic and pulse pressure. Modelling showed that central aortic pulse pressure was associated with cardiovascular events.

Dr Rubin Minhas, a Kent GP and CHD lead for Medway PCT, said this follows on from earlier research from ASCOT that suggested that using different drugs to achieve the same BP can have different effects on cardiovascular risk.

'We don't have a method of measuring central BP, and, until studies show it is practical, we don't need one,' he said.

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