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Objectives. The present study was designed to assess whether a diuretic- or an angiotensin-converting enzyme inhibitor–based treatment can reduce arterial wall hypertrophy of a distal muscular medium-sized artery—the radial artery—and the stiffness of a proximal large elastic artery—the common carotid artery.

Background. Large-artery wall thickness and stiffness are increased during sustained essential hypertension and contribute to the increased risk of complications. Whether antihypertensive treatment can normalize the wall hypertrophy of conducting arteries has not yet been determined.

Methods. Seventy-seven elderly hypertensive patients were randomized to receive 9 months of double-blind treatment with perindopril (2 to 8 mg/day) or the diuretic combination of hydrochlorothiazide (12.5 to 50 mg/day) plus amiloride (1.25 to 5 mg/day) after a 1-month placebo washout period. If systolic blood pressure …