New European studies on atherosclerosis in hypertension

The evidence that some classes of antihypertensive drugs, particularly the calcium antagonists and the ACE-inhibitors, have an antiatherogenic action, at least partly independent of the antihypertensive one, is largely based on a series of experimental studies. The few clinical studies completed so far have been performed on coronary lesions of patients with ischemic heart disease. However, the issue of the anti-atherosclerotic action of antihypertensive agents can best be explored in hypertensive patients. Ultrasound quantitative evaluation of the development of asymptomatic carotid artery atherosclerotic lesions can now be used as end point for trials comparing the efficacy of different antihypertensive compounds. Stimulated by the design of the MIDAS trial (Multicenter Isradipine/Diuretic Atherosclerosis Study), based in USA, several trials have been planned and are being conducted in Europe.