Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiology

Hypertension is a major risk factor for cardiovascular morbidity and mortality. Central blood pressure (CBP) has been shown to be more predictive of outcome than the peripheral BP. Automated office BP (AOBP) technique has several advantages over manual BP Aim of the work: The aim of our study is to evaluate the effect of representatives of the three major classes of antihypertensive drugs on CBP using AOBP measurement Methodology: A total of 90 hypertensive patients were divided into three equal groups: Group (A) received an angiotensin converting enzyme inhibitor [ACEi] (Enalapril), Group (B) received an angiotensin receptor blocker [ARBs] (Losartan), and Group (C) received a calcium channel blocker [CCB] (Amlodipine). Patients were enrolled from the Specialized Hypertension Clinics. Office BP was measured using a digital device (Omron-6 automated device), CBP was measured using AOBP device (The Mobil-O-Graph). The measurements were taken at baseline and after control of BP to goal (2 weeks up to 2 months) Results: We enrolled 90 patients with mean age of 54.6 ± 12.2 years, 38 (42.2. %) patients were males. SBP measurements were significantly higher in the office readings compared to both the sequential and the CBP with a P value < 0.001. At follow up, Group A showed the highest magnitude of reduction of central SBP [(20.7 ±11.4) mmHg vs group B (17.9 ±3.2) mmHg vs group C (14.4 ±8.8) mmHg, P value < 0.02] and central DBP (17.4 ±11.4) mmHg vs group B (11.1 ±2.3) mmHg vs group C (9.8 ±9.0)mmHg, P value < 0.002]. Conclusion: There are important differences between the classes of antihypertensive drugs regarding their effects on BP. ACE inhibitors have a more beneficial effect on reduction of CBP

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