Limited data are available on the effects of nifedipine gastrointestinal therapeutic system (GITS) on arterial stiffness in hypertensive Chinese patients. This study evaluated the efficacy of nifedipine GITS on arterial stiffness and structural vascular lesions in mild hypertensive Chinese patients with increased pulse wave velocity (PWV).Design and method:
This single-center, single-group, open-label, prospective, phase IV study recruited patients with mild hypertension and increased PWV from December 2013 to December 2014 (N = 138; age, 18–75 years; systolic blood pressure (SBP),>140 mmHg,<160 mmHg; diastolic BP (DBP),>90 mmHg,<100 mmHg; increased brachial-ankle PWV [baPWV,12 ms1]). Nifedipine GITS (30 mg/d) was administered for 24 weeks to achieve target BP of <140/90 mmHg. The dose was up-titrated of 60 mg/d in case of unsatisfactory BP reduction after 4 weeks. Primary study end point was the change in baPWV after nifedipine GITS treatment. Hemodynamic parameters (office BP, 24-h ambulatory BP monitoring (ABPM), heart rate (HR) and baPWV) were evaluated at baseline and followed-up at 2, 4, 8, 12, 18 and 24 weeks.Results:
A majority of the patients (n = 117; 84.8%) completed the study. baPWV decreased significantly at 4 weeks compared with baseline (1598.87 ± 239.82 cm/s vs. 1500.89 ± 241.15 cm/s,P < .001) and remained stable at 12 weeks (1482.24 ± 215.14 cm/s,P < .001) and maintained steadily up to 24 weeks (1472.58 ± 205.01 cm/s,P < .001). Office BP reduced from baseline to week 4 (154/95 mmHg vs 136/85 mmHg) and maintained until 24 weeks. Nifedipine GITS significantly decreased 24-h ABPM (P < .001) after 24 weeks from baseline. Mean arterial pressure (MAP) and pulse pressure were lowered significantly after 4, 12 and 24 weeks treatment (P < .001). HR did not change significantly at any time point compared with baseline (P > .05). Multiple linear regression analysis revealed that baPWV were significantly correlated with changes in SBP, DBP, and MAP (P < .05), but not with changes in pulse pressure (P > .05).Conclusions:
baPWV was significantly decreased after the administration of nifedipine GITS in patients with mild hypertension and increased PWV. Improvement in arterial stiffness was seen after 4 weeks, reflecting the BP-lowering effects of nifedipine GITS.