Background: Aorto-femoral pulse wave velocity (PWV) is a well established method to stratify hypertensive patients, but information about the influence of treatment on this variable is scarce.

Methods: Longitudinal study that included 212 (122 men, 56 %) non-diabetic, never treated hypertensive patients. We measured at the initial visit standard clinical variables, as well as PWV (Sphygmocor-System), left ventricular mass index (echocardiography) and microalbuminuria to asses target organ damage. At a median of 1,07 (SD±0,34) years, a second visit was performed, measures were repeated.

Results: The mean age was 50±13 years with initial systolic and diastolic BP of 148/88 mmHg (SD±16/10). The initial prevalence of left ventricular hypertrophy (LVH), pathological urinary albumin excretion rate (UAER) and PWV > 12 m/sec were 30,7, 15,0 and 9,2 %, respectively. Considering a decrease of 1 m/seg as a significant change in PWV, 43 % of patients showed an improvement in PWV. In a logistic multivariate regression analysis, age (OR: −0,9, p<0,0001), systolic BP reduction > 15 mmHg (OR: 2,9, p<0,005), initial Cholesterol-LDL (OR: 1,1, p<0,006), use of angiotension-receptor-blockers (ARB) (OR: 2,5, p<0,022) and waist diameter (OR: −0,95, p<0,04) were independently associated with a decrease of PWV.

Conclusions: In untreated hypertensive patients, age and abdominal obesity are negative predictors of changes in PWV, whereas BP treatment, high cholesterol-LDL and use of ARB seem to favour a decrease of PWV during the first year of treatment.