The Effect of Antihypertensive Drugs on Arterial Stiffness and Central Hemodynamics: Not All Fingers are Made the Same

M. Doumas1, 2, *, E. Gkaliagkousi1, N. Katsiki1, A. Reklou1, A. Lazaridis 1, A. Karagiannis 1
1 2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
2 VAMC and George Washington University, Washington, DC, USA

© 2013 Doumas et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the 49 Konstantinoupoleos street, Hippokration Hospital, 54643, Thessaloniki, Greece; Tel: +30 2310992836; Fax: +30 2310992834; Email:


Arterial stiffness and central hemodynamics attract increasing scientific interest within the hypertensive community during the last decade. Accumulating evidence indicates that aortic stiffness is a strong and independent predictor of cardiovascular events and all-cause mortality in hypertensive patients, and its predictive value extends beyond traditional risk factors. The role of central hemodynamics and augmentation index (a marker of reflected waves), remains less established and requires further investigation. Several lines of evidence indicate that antihypertensive therapy results in significant reductions of pulse wave velocity and central hemodynamics. However, beta-blockers seem to be the only exception with significant within-class differences. Conventional beta-blockers, although equally effective in reducing pulse wave velocity, seem to be less beneficial on central hemodynamics and augmentation index than the other antihypertensive drug categories, whereas the newer vasodilating beta-blockers seem to share the benefits of the other antihypertensive drugs. In conclusion, aortic stiffness seems ready for ‘prime-time’ in the management of essential hypertension, while further research is needed for central hemodynamics and augmentation index.

Keywords: Arterial stiffness, pulse wave velocity, augmentation index, central hemodynamics, aortic blood pressure, antihypertensive drugs, beta-blockers.