Arterial stiffness parameters during six-month antihypertensive therapy: a prospective observational study.

AIM: To investigate the prevalence of arterial stiffness in hypertensive patients in Bosnia and Herzegovina and to assess the effects of various antihypertensive therapies on arterial stiffness. METHODS: This prospective, open-label clinical study enrolled 200 patients who met predefined inclusion criteria from a total of 217 screened between 1 November 2023 and 30 April 2024. Participants were followed for six months. Thirteen distinct antihypertensive treatment combinations were evaluated. RESULTS: In 200 patients, six months of antihypertensive treatment significantly reduced systolic blood pressure from 136.06 ± 15 to 130.69 ± 12 mmHg and diastolic blood pressure from 85.35±9 to 82.69±7 mmHg. Pulse wave velocity (PWV) changed only minimally, from 8.09±1.5 m/s to 8.05±1.2 m/s (p=0.354). Augmentation index (AIx) improved from 25.17% to 23.33%. The greatest reduction in PWV was observed with angiotensin-converting enzyme inhibitors plus statins (-0.19 m/s), while the largest reduction in AIx was seen with angiotensin-converting enzyme inhibitors, calcium channel blockers, beta blockers, diuretics, and statins (-15.64%, p<0.001). Baseline systolic blood pressure was the strongest, although weak, predictor of pulse wave velocity reduction (AUC=0.627, p=0.002). CONCLUSION: The study demonstrated a high prevalence of increased arterial stiffness among hypertensive patients, with higher values associated with greater cardiovascular risk. Routine assessment of arterial stiffness, alongside standard blood pressure measurement, may improve cardiovascular risk stratification and support more effective, individualized hypertension management.