Impact of vascular remodeling and of heart rate variability on antihypertensive and cardiovascular effects of indapamide retard in hypertensive patients
Abstract
Objective. To compare the antihypertensive and cardiovascular protection effects of Indapamide retard in response to arterial remodeling and heart rate variability (HRV) in hypertensive patients. Design and methods. Structural and functional indices of heart and brachial artery (BA) by ultrasound examination, circadian blood pressure (BP) rhythm and HRV by 24-hour ECG and BP monitoring were assessed at baseline and after 6-month therapy with Indapamide retard. Patients were divided into 2 groups: 1st group included 37 patients without arterial remodeling; 2nd group - 48 patients with arterial remodeling. Results. Antihypertensive effect of Indapamide retard did not differ in groups. Changes of HRV indices were signifi cantly higher in 1st group, but the regression of vessel remodeling and increasing of endothelium-dependent vasodilation were signifi cant in 2nd group. Conclusion. This study shows that cardiac protection and antihypertensive effects of Indapamide retard realize through autonomic modulation effect in absence of vascular remodeling, but direct vascular effect is observed in patients with vascular remodeling.