HOPE-3 arterial compliance sub-study

This National Heart Foundation (NHF) funded sub-study study will assess the independent and the combined effects of blood pressure lowering and lipid lowering on arterial stiffness in approximately 300 of the HOPE-3 study participants who attend CTC.

The mechanisms through which reductions in blood pressure and lipids lower the risk of cardiovascular events are not fully understood.  However in recent years, great emphasis has been placed on the role of arterial stiffness in the development of cardiovascular disease.  Aortic pulse wave velocity (PWV), a marker of aortic stiffness, is a strong independent predictor of cardiovascular morbidity and mortality as shown in numerous studies in different populations.  One of the mechanisms for the benefits of blood pressure lowering and lipid lowering may be through an affect on PWV.  However no studies to date have compared the effect of lipid lowering versus blood pressure lowering in isolation or combination on pulse wave velocity.

During the HOPE-3 run-in period, subjects will be provided with information on participation in the arterial stiffness sub-study.  They are only eligible to participate in the sub-study if they remain eligible to be randomised to HOPE-3 study.  Prior to receipt of study medication, those subjects volunteering for the sub-study will undertake arterial stiffness assessment at the Clinical Trial Centre.  Pulse wave velocity (PWV) is measured between the carotid artery and both the femoral artery using non-invasive applanation tonometry.  Systemic arterial compliance is a non-invasive test of the elasticity of the arteries and involves measurements of blood pressure and blood flow using ultra-sound transducers positioned above the sternum to image the ascending aorta.  The sub-study recruitment will begin in 2008.