Rehman A, Rahman A R A, Rasool A H G
Department of Pharmacology, School of Medical Science, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan.
J Hum Hypertens. 2002 Apr;16(4):261-6. doi: 10.1038/sj.jhh.1001372.
The objective of this study was to examine the effect of angiotensin II (Ang II) and angiotensin II type 1 (AT(1)) receptor blockade on pulse wave velocity (PWV) in healthy humans. We studied nine young male volunteers in a double-blind randomised crossover design. Carotid-femoral PWV (an index of arterial stiffness) was measured by using a Complior machine. Subjects were previously treated for 3 days with once-daily dose of either a placebo or valsartan 80 mg. On the third day, they were infused with either placebo or 5 ng/kg/min of Ang II over 30 min. Subjects thus received placebo capsule + placebo infusion (P), valsartan + placebo infusion (V), placebo + Ang II infusion (A), and valsartan + Ang II infusion (VA) combinations. Heart rate (HR), blood pressure and PWV were recorded at baseline and then every 10 min during infusion and once after the end of infusion. There were significant increases in systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) with A compared with P (P = 0.002, P = 0.002, P = 0.001 respectively). These rises in blood pressure were completely blocked by valsartan. A significant rise in PWV by A was seen compared with P (8.38 +/- 0.24 vs 7.48 +/- 0.24 m/sec, P = 0.013) and was completely blocked by valsartan; VA compared with P (7.27 +/- 0.24 vs 7.48 +/- 0.24 m/sec, P = NS). Multiple linear regression analysis showed that blockade of Ang II induced increase in blood pressure by valsartan contributed to only 30% of the total reduction in Ang II induced rise in PWV (R(2) = 0.306). The conclusions were that valsartan completely blocks the effect of Ang II on PWV. The effect of Ang II on PWV is mediated through AT(1)receptors. Reduction in PWV by Ang II antagonist is not fully explained by its pressure lowering effect of Ang II and may be partially independent of its effect on blood pressure.
本研究的目的是检测血管紧张素II(Ang II)及血管紧张素II 1型(AT(1))受体阻断对健康人脉搏波速度(PWV)的影响。我们采用双盲随机交叉设计对9名年轻男性志愿者进行了研究。使用Complior仪器测量颈股PWV(动脉僵硬度指标)。受试者先前接受了为期3天的每日一次剂量的安慰剂或80 mg缬沙坦治疗。在第3天,他们在30分钟内接受了安慰剂或5 ng/kg/min的Ang II静脉输注。受试者因此接受了安慰剂胶囊+安慰剂输注(P)、缬沙坦+安慰剂输注(V)、安慰剂+Ang II输注(A)以及缬沙坦+Ang II输注(VA)组合。在基线时记录心率(HR)、血压和PWV,然后在输注期间每10分钟记录一次,输注结束后再记录一次。与P相比,A组的收缩压(SBP)、舒张压(DBP)和平均动脉压(MAP)显著升高(分别为P = 0.002、P = 0.002、P = 0.001)。这些血压升高被缬沙坦完全阻断。与P相比,A组的PWV显著升高(8.38±0.24 vs 7.48±0.24 m/sec,P = 0.013),且被缬沙坦完全阻断;VA组与P组相比(7.27±0.24 vs 7.48±0.24 m/sec,P = 无显著差异)。多元线性回归分析显示,缬沙坦对Ang II诱导血压升高的阻断仅占Ang II诱导PWV升高总降低量的30%(R(2) = 0.306)。结论是缬沙坦完全阻断了Ang II对PWV的影响。Ang II对PWV的作用是通过AT(1)受体介导的。Ang II拮抗剂降低PWV的作用不能完全由其降低Ang II血压的作用来解释,可能部分独立于其对血压的影响。