AFFECTING CENTRAL AORTIC SYSTOLIC PRESSURE: HEART RATE RATHER THAN ANTIHYPERTENSIVE MEDICATION

Objectives: It's unclear whether the effect of antihypertensive medication on central aortic systolic pressure (CASP) relied on heart rate (HR) or medication itself. We aim to explore the effects of different antihypertensive medication on CASP in primary hypertensive patients. Methods: 119 untreated and 371 treated hypertension patients were recruited. Brachial blood pressure, HR, CASP were measured in rest and 30 minutes after the administration of Metoprolol Tartrate (25 mg, n = 46) or Diltiazem (60 mg, n = 32) or ivabradine (5 mg, n = 41) in untreated hypertension patients. The difference between brachial systolic pressure and CASP (SBP-CASP) was compared among three groups. Long-term effects of major antihypertensive medication on CASP in treated hypertension patients were also determined. Results: (1) Drugs ranked by HR lowing property of short-term medication administration were Metoprolol > ivabradine > Diltiazem (−10.11 > −4.98 > −3.38 bpm), and drugs ranked by SBP-CASP descending property were Metoprolol > ivabradine > Diltiazem (−2.83 > −1.68 > −1.16 mmHg). (2) HR and SBP-CASP were similar among long-term administration of calcium channel blocker, the renin-angiotensin-system inhibitor and beta-blocker (HR: 74.39 ± 10.70, 72.95 ± 10.41 and 71.08 ± 8.90 bpm, p > 0.05; SBP-CASP: 9.21 ± 5.58, 10.29 ± 4.19 and 8.38 ± 3.59 mmHg, p > 0.05). (3) All subjects were classified into four categories by HR: ≤64, 65–72, 73–80 and ≥81 bpm. SBP-CASP for the four categories were 7.07 ± 2.97, 6.94 ± 3.05, 8.74 ± 3.40 and 11.94 ± 5.40 mmHg, respectively (p < 0.05). Conclusion: The effect of different antihypertensive medication on central aortic systolic pressure in primary hypertensive patients may lie in their effects on HR rather than medication itself.