Structure and function of resistance arteries of hypertensive patients treated with a p-blocker or a calcium channel antagonist

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Abstract
To investigate the effects on resistance artery structure and function of monotherapy with the β-blocker atenolol or the calcium channel antagonist nifedipine in its once a day form or gastrointestinal therapeutic system (GITS). Twenty well-controlled essential hypertensive patients matched for age, body mass index, duration and severity of hypertension. Normotensive subjects and untreated hypertensives served as the reference groups. Resistance-size small arteries (standardized lumen diameter 247 ± 8µ m) were dissected from a gluteal subcutaneous biopsy, and studied both on a wire myograph and as pressurized vessels. The media width:lumen diameter ratio of arteries was 5.37 ± 0.09% in normotensive subjects, 5.38 ± 0.18% in patients treated with nifedipine GITS, 6.81 ± 0.18% in patients treated with atenolol and 7.08 ± 0.12% in untreated hypertensives (for each of the latter two groups PConclusion Hypertensive patients with well-controlled blood pressures under treatment for more than 1 year with the once-a-day calcium channel antagonist nifedipine GITS exhibit normal structure and function of gluteal subcutaneous small arteries, whereas similar patients with blood pressure equally well controlled by the β-blocker atenolol present thicker small arteries with abnormal endothelium- dependent relaxation and altered contractility. Whether this finding applies also to other vascular beds, and whether it is associated with a better outcome in relation to morbidity and mortality resulting from elevated blood pressure, remain to be established.

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