{"id":"fb176553eea8","type":"article","url":"https://hartvaat.nl/2024/07/01/bloeddrukverlaging-en-polsgolfsnelheid-meta-analyse/","title":"Bloeddrukverlaging en polsgolfsnelheid: meta-analyse","title_en":"Influence of Blood Pressure Reduction on Pulse Wave Velocity in Primary Hypertension: A Meta-Analysis and Comparison With an Acute Modulation of Transmural Pressure.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","internist"],"tags":["bloeddrukbehandeling"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.123.22436","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.123.22436","authors":["Ryan J McNally","Andrii Boguslavskyi","Rayka Malek","Christopher N Floyd","Marina Cecelja","Abdel Douiri","Rosa-Maria Bruno","Bushra Farukh","Phil Chowienczyk","Luca Faconti"],"significance":5,"published":"2024-07-01","source_date":"2024-07-01","image":"","kennis":[],"congress":"","summary_en":"A meta-analysis examined the effect of antihypertensive treatment on aortic pulse wave velocity. Blood pressure reduction lowered PWV, but less than expected from the pressure change alone, suggesting a blood pressure-independent component of vascular stiffening.","created":"2026-07-03T10:31:00Z","updated":"2026-07-03T13:30:03Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse onderzocht het effect van bloeddrukverlaging op de aortale polsgolfsnelheid. Bloeddrukverlaging vermindert de PWV, maar het effect is kleiner dan verwacht op basis van de drukverandering, wat een bloeddruk-onafhankelijk vaateffect suggereert.","abstract_original":"BACKGROUND: Increased arterial stiffness and pulse wave velocity (PWV) of the aorta and large arteries impose adverse hemodynamic effects on the heart and other organs. Antihypertensive treatment reduces PWV, but it is unknown whether this results from an unloading of stiffer elements in the arterial wall or is due to an alternate functional or structural change that might differ according to class of antihypertensive drug. METHODS: We performed a systematic review and meta-analysis of the effects of different antihypertensive drug classes and duration of treatment on PWV with and without adjustment for change in mean arterial blood pressure (BP; study 1) and compared this to the change in PWV after an acute change in transmural pressure, simulating an acute change in BP (study 2). RESULTS: A total of 83 studies involving 6200 subjects were identified. For all drug classes combined, the reduction of PWV was 0.65 (95% CI, 0.46-0.83) m/s per 10 mm Hg reduction in mean arterial BP, a change similar to that induced by an acute change in transmural pressure in a group of hypertensive subjects. When adjusted for change in mean arterial BP, the reduction in PWV after treatment with beta-blockers or diuretics was less than that after treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor antagonists or calcium channel antagonists. CONCLUSIONS: Reduction in PWV after antihypertensive treatment is largely explained by the reduction in BP, but there are some BP-independent effects. These might increase over time and contribute to better outcomes over the long term, but this remains to be demonstrated in long-term clinical trials."}