The Different Long-term Effect of Compliance or Non-compliance of Amlodipine and Perindopril Treatment Regimen on the Structure and Function of Brachial Artery in Hypertensive Patients

Objective To investigate the long term effect of adherence to amlodipine and perindopril treatment regimen on the changes in structure and function of brachial artery in hypertensive patients. Methods Sixty seven patients with essential hypertension with BP≥160/100 mmHg were treated with amlodipine（2.5-10 mg/d） and perindopril （2-8 mg/d） for （3.2±0.4） years. The brachial artery intimal-medial thickness （IMT）, lumen diameter（r）, IMT/r, flow mediated vasodilatation （FMD） and cross sectional compliance（CSC） were measured with high resolution ultrasonography before and after 1 year and 3 years of treatment. At the end of the study, the ultrasongraphic parameters were analyzed based on whether they adhere to the treatment regimen. 31 patients were included into compliance group （group A）, while 36 patients in non-compliance group （B）. Thirty-three healthy subject served as control （group C）. Results Before treatment, compared with group C, group A and B had thicker IMT（group A: 0.55±0.12, group B: 0.55±0.10） mm vs control（0.42±0.04）mm, lower FMD （6.4±1.7, 6.5±1.6 vs 10.4±2.2） and lower CSC（11.89±4.93, 11.94±5.07 vs 26.55±3.44） 10 -3 mm2·mmHg -1 , all P＜0.01. After treatment for 3 years the IMT, FMD and CSC in group A were substantially improved compared with baseline IMT:（0.39±0.06 vs 0.55±0.12） mm, FMD:16.9±3.6 vs 6.4±1.7; CSC:（18.66±4.67 vs 11.9±4.9） 10 -3 mm2·mmHg -1 , all P＜0.01. The differences between group A and B in IMT, FMD and CSC was significant IMT:（±0.06 vs 0.54±0.11） mm, FMD:16.9±3.6 vs 8.9±1.2,CSC:18.7±4.7 vs 15.9±3.9) 10 -3 mm2·mmHg -1 , P＜0.01. Conclusion Long term antihypertensive therapy with amlodipine and perindopril has profound effect on the regression of the abnormal structure and function of brachial artery. Our study demonstrates the obvious differences in the outcome of compliance or non-compliance to the therapy regimen.