REGIONAL ARTERIAL HEMODYNAMICS AND CAROTI D CIRCULATION IN ESSENTIAL-HYPERTENSION - APPLICATION TO NITRENDIPINE IN SUBJECTS AGED OVER 40

Lesions of the arterial wall constitute one of the main complications of essential hypertension. The final objective of all antihypertensive drugs is to reduce the cardiovascular morbidity and mortality rates, but their short and medium term objectives must be to normalise blood pressure values and to correct the functional and structural abnormali ties consecutives to arterial hypertension. In this double-blind drug versus placebo study conducted in 20 patients (14 men, 6 women) aged o ver 40, the effects of nitrendipine on regional arterial haemodynamics (aortic territory, upper limb, lower limb) and carotid circulation we re evaluated. Nitrendipine was administered daily in doses of 20 mg du ring 1 month. After 4 weeks of treatment, the treated group showed a f all in blood pressure and an improvement in the pulse wave propagation (an index of arterial distensibility) in the carotido-femoral territo ry (11.4 +/- 1.7 vs 9.9 +/- 1.6 m/s ; P < 0.01) and in the humero-radi al territory (12.9 +/- 2.0 vs 11.6 +/- 2.1 m/s ; P < 0.05) ; there was no change in the femoro-tibial territory (13.2 +/- 1.8 vs 12.5 +/- 1. 7 m/s ; NS). The haemodynamics of the common carotid artery showed no change in carotid diameter or blood velocity, and small lowering of lo cal resistances (28.1 +/- 9.1 vs 24.6 +/- 4.9 mmHg. s. ml-1; P < 0.05) . This study demonstrates that in patients older than 40 years a long- term treatment with nitrendipine lowers blood pressure, does not alter the common carotid flow and improves arterial distensibility. The art erial effects seem to vary according to the arterial territories consi dered.