The antiatherogenic effects of antihypertensive treatment: trials completed and ongoing.

B-mode ultrasonography provides a reliable means of measuring carotid artery wall intima-media thickness. Because carotid intima-media thickness is correlated with blood pressure and is predictive of future cardiovascular events, it can be used as an endpoint in intervention trials. Inclusion of carotid bifurcation in the measurements appears necessary for inferences about atherosclerosis. Several intervention studies using antihypertensive agents have been completed and others are ongoing. Placebo-controlled studies have shown beneficial effects of calcium antagonists and beta-blockers, and contradictory responses with angiotensin converting enzyme inhibitors, but none of these studies have been performed in hypertensive patients. In hypertensive patients, three studies comparing different antihypertensive agents have been completed, with some evidence favoring calcium antagonists over diuretics. Two studies are ongoing, and should be completed and published soon.