Of the 15 trials having a cross-over design (table ?(table3)3) [1,2,3,4,5,10,30,31,32,33,34,35,36,37,38] and 31 tests having a parallel-group comparison design (table ?(table4)4) [13,16,23,26,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65], 6 [1,2,3,4,5,10] and 4 [13,16,23,26], respectively, were portion of placebo-controlled studies. relevant for cardiovascular safety and prevention remains to be investigated. strong class=”kwd-title” KEY PHRASES: Antihypertensive medicines, Arterial stiffness, Wave reflections, Randomized controlled trial Introduction In the past 2 decades, noninvasive measurements of arterial function are progressively used as an intermediate measure of cardiovascular disease risk in restorative tests, such as antihypertensive therapy. Among numerous guidelines of arterial function, pulse wave velocity and augmentation index measure arterial tightness and wave reflections, respectively. Both actions can be accurately estimated within minutes with easy-to-use products and may forecast cardiovascular events above and beyond standard cardiovascular risk factors, such as high blood pressure [1,2]. However, at present, there is no specific treatment for improved arterial tightness or wave reflections. Nonetheless, antihypertensive medicines, especially those of vasodilatating action, seem to be encouraging in this regard. Since the early 1990s, several randomized controlled tests have been carried out to study the results of various antihypertensive medicines on carotid-femoral or brachial-ankle pulse wave velocity and augmentation index. In the present review article, we summarized these tests to investigate whether and which antihypertensive medicines are efficacious in reducing arterial tightness and wave reflections and to explore the medical relevance of these arterial measurements for cardiovascular safety and prevention. Arterial Effects of Antihypertensive Medicines in Placebo-Controlled Tests Of the 27 placebo-controlled tests, 11 experienced a CVT 6883 cross-over design (table ?(table1)1) [3,4,5,6,7,8,9,10,11,12,13] and 16 had a parallel-group comparison design (table ?(table2)2) [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29]. Regardless of the design, these placebo-controlled studies had a sample size of tens and a follow-up time of weeks. Table 1 Randomized placebo-controlled double-blind cross-over studies thead th align=”remaining” rowspan=”1″ colspan=”1″ First author [Ref.] /th th align=”remaining” Fip3p rowspan=”1″ colspan=”1″ Yr /th th align=”remaining” rowspan=”1″ colspan=”1″ Subjects /th th align=”remaining” rowspan=”1″ colspan=”1″ Individuals, n /th th align=”remaining” rowspan=”1″ colspan=”1″ Antihypertensive treatment(s) /th th colspan=”2″ align=”remaining” rowspan=”1″ Results hr / /th th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ /th th align=”remaining” rowspan=”1″ colspan=”1″ arterial tightness /th th align=”remaining” rowspan=”1″ colspan=”1″ wave reflections /th /thead em ACEIs /em Pannier [3]2001EH20perindoprilAUC cfPWV NSAUC AIx perindopril betterDeary [4]2002EH30lisinoprilnot measuredAIx NSMorgan [5]2004EH32ACEIsnot measuredAIx NSHirata [6]2005CAD30ramiprilcfPWV ramipril betterAIx and AIx@HR75 ramipril betterTurner [7]2006intracranial aneurysms19perindoprilnot measuredAIx NS hr / em ARBs /em Asmar [8]2002EH/DM20telmisartancfPWV telmisartan betterAIx NSRajagopalan [9]2006healthy volunteers33valsartancfPWV NSAIx NSTurner [7]2006intracranial aneurysms19irbesartannot measuredAIx NSKaufman [10]2010EH10losartannot measuredAIx NS hr / em -Blockers /em Asmar [11]1991EH14bisoprololcfPWV bisoprolol betternot measuredPannier [3]2001EH20atenololAUC cfPWV atenolol betterAUC AIx NSDeary [4]2002EH30bisoprololnot measuredAIx bisoprolol betterMorgan [5]2004EH32-blockersnot measuredAIx NSHirata [6]2005CAD30atenololcfPWV atenolol betterAIx atenolol worse; AIx@HR75 NSDhakam [12]2008EH16nebivolol atenololaPWV nebivolol better aPWV atenolol betterAIx nebivolol worse AIx atenolol worse hr / em CCBs /em Deary [4]2002EH30amlodipinenot measuredAIx NSMorgan [5]2004EH32CCBsnot measuredAIx NS hr / em Diuretics /em Deary [4]2002EH30bendrofluazidenot measuredAIx NSMorgan [5]2004EH32diureticsnot measuredAIx NSDavies [13]2005EH/DM10spironolactonecrPWV spironolactone betternot measured Open in a separate windowpane ACEIs = ACE inhibitors; AIx = augmentation index; AIx@HR75 = AIx corrected for heart rate of 75 beats/min; aPWV = aortic pulse wave velocity; AUC = area under the curve; CAD = coronary artery disease; cfPWV = carotid-femoral pulse wave velocity; crPWV = carotid-radial pulse wave velocity; DM = diabetes mellitus; EH = essential hypertension; NS = not significantly different. Table 2 Randomized placebo-controlled parallel-group assessment studies thead th align=”remaining” rowspan=”1″ colspan=”1″ First author [Ref.] /th th align=”remaining” rowspan=”1″ colspan=”1″ Yr /th th align=”remaining” rowspan=”1″ colspan=”1″ Design /th th align=”remaining” rowspan=”1″ colspan=”1″ Subjects /th th align=”remaining” rowspan=”1″ colspan=”1″ Individuals, n /th th align=”remaining” rowspan=”1″ colspan=”1″ Antihypertensive treatment(s) /th th colspan=”2″ align=”remaining” rowspan=”1″ Results hr / /th th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ CVT 6883 colspan=”1″ /th th align=”remaining” rowspan=”1″ colspan=”1″ arterial tightness /th th align=”remaining” CVT 6883 rowspan=”1″ colspan=”1″ wave reflections /th /thead em ACEIs /em Kahonen [14]1998DBhealthy volunteers15captoprilcfPWV captopril betternot measuredDart [15]2001openEH111perindoprilnot measuredAIx NSIchihara [16]2005Chemodialysis individuals42trandolaprilbaPWV trandolapril betternot measuredYu [17]2006DBhemodialysis individuals46ramiprilcfPWV NSAIx NSTsang [18]2006DBIDD21quinaprilnot measuredAIx NSAhimastos [19]2007DBMarfan syndrome17perindoprilcfPWV and faPWV perindopril betternot measuredRahman [20]2007DBDM19ramiprilcfPWV NSAIx NSIGT21ramiprilcfPWV NSAIx ramipril betterMitchell [21]2007openCAD300trandolaprilcfPWV trandolapril betterAIx NSAhimastos [22]2008DBPAD40ramiprilcfPWV ramipril betterAIx ramipril better hr / em ARBs /em Klingbeil [23]2002DBEH40valsartannot measuredAIx valsartan betterIchihara [16]2005Chemodialysis individuals43losartanbaPWV NSnot measuredMitsuhashi [24]2009CEH/hemodialysis individuals40losartanbaPWV NSnot measured hr / em ?-Blockers /em Kahonen [14]1998DBhealthy volunteers15propranololcfPWV propranolol betternot measuredKahonen [25]2000DBhealthy volunteers31bisoprolol, celiprolol, and propranololcfPWV bisoprolol.