Effect of Colchicine on Arterial Stiffness in Patients With Hypertension: The COlchicine HypERtENsion Trial (COHERENT).

Aim

This trial investigated whether colchicine, an anti-inflammatory treatment, affects cardiovascular structure and function, assessed by arterial stiffness, blood pressure and biochemistry, compared with placebo.

Methods

COHERENT was a randomized, double-blind, placebo-controlled trial of the effects of colchicine on arterial stiffness in adults with pharmacologically treated hypertension without cardiovascular disease. Eligible patients were randomized 1:1 to colchicine 0.5mg daily or placebo for six months. Assessment of arterial stiffness, echocardiography, and biomarker measurement were performed at baseline and six months. The primary endpoint was change in carotid-femoral pulse wave velocity (cfPWV). Secondary endpoints included change in blood pressure (BP), left ventricular mass index, as well as change in cardiac and inflammatory biomarkers.

Results

Of 183 screened, 150 were randomized (75 per group). Mean age was 64.5 (±8.0) years, 53 (35.3%) were female, and mean systolic blood pressure was 137.6 (±15.6) mmHg. At six months, cfPWV did not differ between groups (between-group difference in ΔcfPWV -0.1m/s, 95% CI: -0.5 to 0.3m/s, p=0.53). Office systolic BP decreased significantly more in the placebo group than in the colchicine group (between-group difference in Δoffice systolic BP 5.7 mmHg, 95% CI: 1.0 to 10.5 mmHg, p=0.018. hsCRP decreased significantly in the colchicine group compared with the placebo group (between-group difference in % change in hsCRP -39.8%, 95% CI: -59.1 to -11.4%, p=0.010). Left ventricular mass index or cardiac biomarkers did not differ between groups.

Conclusions

Six months of colchicine did not affect arterial stiffness in pharmacologically treated hypertension without cardiovascular disease. Colchicine significantly decreased hsCRP.