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Impact of arterial stiffness reduction on urinary albumin excretion during antihypertensive treatment: the Japan morning Surge-1 study

Matsui, Yoshio; Eguchi, Kazuo; Shibasaki, Seiichi; Ishikawa, Joji; Hoshide, Satoshi; Shimada, Kazuyuki; Kario, Kazuomion behalf of the JMS-1 study group

doi: 10.1097/HJH.0b013e32833a3981
Original papers: Therapeutic aspects
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Objectives There has been no report investigating the impact of the arterial stiffness reduction induced by antihypertensive medications on the improvement of target organ damage in hypertension. The aim of this study was to assess the association of the change in pulse wave velocity (PWV) with that in urinary albumin excretion as a measure of renal damage.

Methods We studied 404 treated hypertensive patients (mean age, 70.5 ± 9.5 years), who were allocated to either an active treatment group (doxazosin and atenolol when needed) or a control group. Blood pressure, urinary albumin-to-creatinine ratio (UACR), and brachial–ankle PWV (baPWV) were measured at baseline and after 6 months of treatment.

Results In the total population, home/office SBP, UACR, and baPWV decreased significantly from the baseline. In multivariate regression analyses, ΔbaPWV was significantly associated with ΔUACR, independent of Δhome SBP (β = 0.21, P < 0.001). When the patients were divided into a group with ΔbaPWV of at least 0 cm/s (positive ΔPWV) and a group with ΔbaPWV of less than 0 cm/s (negative ΔPWV), the reduction of UACR was greater in the latter group, even after adjustment for the covariates including the change in home SBP. These results were essentially the same when office SBP was entered in place of home SBP, and similar both in the active treatment group and the control group.

Conclusion These findings suggest that the arterial stiffness reduction induced by antihypertensive medications is associated with the improvement of renal damage, independent of home/office SBP reduction.

Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan

Received 2 October, 2009

Revised 19 January, 2010

Accepted 22 March, 2010

Correspondence to Yoshio Matsui, MD, PhD, Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan Tel: +81 285 58 7538; fax: +81 285 44 4311; e-mail: yoshio@jichi.ac.jp

© 2010 Lippincott Williams & Wilkins, Inc.