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Objectives: To study whether inhibition of the renin-angiotensin-aldosterone system has effects on vascular function beyond blood pressure (BP) reduction alone. Methods: Mild-to-moderate hypertensive patients (age 54±12 years, 34% women) were randomized double-blind to ramipril (10 mg od, n=33) or doxazosin (8 mg od, n=28) for 12 weeks. Central BP, pulse wave velocity (PWV), and augmentation index (AIx) were assessed by applanation tonometry (SphygmoCor, AtCor Medical). Endothelial function was studied by forearm post-ischemic flow mediated vasodilatation (FMD) and pulse wave analysis with beta 2-adrenoceptor-agonist stimulation, and by skin microcirculation iontophoresis (acetylcholine and sodium nitroprusside). Results: Baseline central and brachial BP were 140/89 and 148/89 mmHg, carotid and brachial pulse pressures 51 and 60 mmHg, carotid-femoral and carotid-radial PWV 8.8 and 8.9 m/s, and AIx 30.1%. Treatment induced reductions (means±SEM) in central and brachial BP (−7.9±1.1/−6.6±1.1 and −6.0±1.0/−6.8±1.1%; all P |
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