Do arterial effects of antihypertensive drugs depend on subject's serum cholesterol?

Effects of antihypertensive treatment on large arteries may be influenced b y the type of drug and concomitant risk factors such as blood cholesterol. To explore these possibilities we investigated the common carotid artery of 20 subjects with low cholesterol and 19 subjects with high cholesterol. al l with essential hypertension, randomly allocated to 3 months of treatment with nitrendipine (20 mg/d) or trandolapril (2 mg/d). Carotid parameters we re determined by recording instantaneous pressure (applanation tonometry) a nd diameter (echotracking device) and by modeling the pressure-diameter loo p to obtain the Peterson modulus, stiffness index, measured and isobaric co mpliances, and wall viscosity. Effects of drugs on carotid parameters did n ot differ, except on systolic and diastolic diameters (p < 0.01), which inc reased insignificantly under nitrendipine but decreased (p < 0.01) under tr andolapril. Blood cholesterol status did not influence carotid effects of t randolapril, whereas patients with low and high cholesterol treated with ni trendipine exhibited significant differences in drug effects on (a) systoli c and pulse pressures (p < 0.05), which decreased in patients with low chol esterol (p < 0.01, p < 0.05) but not in those with high cholesterol; (b) di astolic diameter (p = 0.05), which increased insignificantly in patients wi th low cholesterol but was unchanged in those with high cholesterol; and (c ) wall viscosity (p < 0.01), which decreased in patients with low cholester ol (p < 0.05) but increased insignificantly in those with high cholesterol. Also, wall viscosity change under nitrendipine was positively related to t he baseline blood cholesterol (r = 0.64, p < 0.01). Thus, nitrendipine and trandolapril show noteworthy differences in their effects on the carotid ar tery, in particular with respect to the status of blood cholesterol, but th ese differences should be confirmed by larger studies.