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Objective: Arterial stiffness (AS) measured as carotid-femoral pulse wave velocity (cfPWV) is an important determinant of cardiovascular risk closely related to brachial blood pressure (BP). Whether it can be changed independently of BP in the short term is uncertain but recent observations suggest that AS may be specifically modulated by the autonomic nervous system (ANS). Here we compared effects of device guided breathing (DGB, known to reduce sympathetic activity) with nifedipine on cfPWV. Design and method: Patients with essential HT on pharmacological treatment (mean ± SD age 48 ± 14 years, n = 19) had cfPWV (SphygmoCor) and brachial BP (Omron) measurements performed before and after DGB and oral administration of nifedipine 10 mg. The two interventions were performed consecutively in single visit with the patient lying in supine position. DGB is a biofeedback technique which slows the breathing rate to <10 breaths/minute and decreases BP via its action on the ANS. Nifedipine is a short acting peripheral arterial vasodilator that tends to increase sympathetic activity. Results: Baseline systolic BP (SBP) 150.4 ± 12.6 and diastolic BP (DBP) 89.8 ± 8.7 mmHg, heart rate (HR) 65.9 ± 11.2 bpm; cfPWV 10.3 ± 2.4 m/s. Compared to nifedipine, DGB caused less reduction of both brachial SBP and DBP: decrease of 12.3 (95%CI 8.4, 16.1) vs. 16.1 (12.7, 19.5) mmHg in SBP for DGB and nifedipine and 5.9 (3.1, 8.7) vs. 10.4 (7.1, 13.5) mmHg in DBP (P < 0.05 for difference between DGB and nifedipine). DGB caused a greater reduction in cfPWV: decrease of 1.2 (0.8, 1.8) and 0.7 (0.1, 1.3) m/s for DGB and nifedipine respectively (P = 0.02 for difference between DGB and nifedipine). HR decreased during DGB by 3.6(1.2, 5.9) bpm and increased after administration of nifedipine: 7.6(3.9, 11.3) bpm. Conclusions: DGB had a greater impact on AS despite a smaller effect on BP. These results demonstrate that cfPWV can be changed independently from BP in the short-term and support a specific role of the ANS in regulating cfPWV.
Original languageEnglish
JournalJournal of Hypertension
Publication statusPublished - 4 Jul 2019


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