De Luca N, Rosiello G, Lamenza F, Ricciardelli B, Marchegiano R, Volpe M, Marelli C, Trimarco B
I Clinica Medica, University of Naples, Milan, Italy.
Am J Cardiol. 1992 Oct 29;70(12):52D-59D. doi: 10.1016/0002-9149(92)90272-z.
In 15 patients with untreated mild to moderate essential hypertension and left ventricular hypertrophy, we assessed blood pressure, echocardiographic left ventricular mass index, brachial artery compliance (pulsed doppler flowmetry), and calculated forearm vascular resistance (strain gauge plethysmography) before, during (6 and 12 months) and after (1 month washout period) 1 year of satisfactory (blood pressure < or = 140/90 mm Hg) antihypertensive therapy with the angiotensin-converting enzyme inhibitor trandolapril (2.0 mg orally once daily). During the antihypertensive effective treatment, we observed a significant reduction of systolic and diastolic blood pressures, left ventricular mass index, and forearm vascular resistance at both 6 and 12 months. In addition, brachial artery compliance was significantly increased. After washout, systolic (156 +/- 3 mm Hg) and diastolic (102 +/- 1 mm Hg) blood pressures returned to levels comparable to baseline. However, left ventricular mass index (132 +/- 4; p < 0.01) and brachial artery compliance (1.53 +/- 0.01; p < 0.01) were still different from baseline. These results demonstrate that chronic antihypertensive treatment with trandolapril is associated with a stable regression of cardiac and vascular abnormalities, which is partially unrelated to the blood pressure lowering effect.
在15例未经治疗的轻至中度原发性高血压伴左心室肥厚患者中，我们评估了在使用血管紧张素转换酶抑制剂群多普利（每日口服一次2.0毫克）进行为期1年的满意降压治疗（血压≤140/90毫米汞柱）之前、期间（6个月和12个月）以及之后（1个月洗脱期）的血压、超声心动图左心室质量指数、肱动脉顺应性（脉冲多普勒血流仪），并计算了前臂血管阻力（应变片体积描记法）。在降压有效治疗期间，我们观察到在6个月和12个月时收缩压和舒张压、左心室质量指数以及前臂血管阻力均显著降低。此外，肱动脉顺应性显著增加。洗脱期后，收缩压（156±3毫米汞柱）和舒张压（102±1毫米汞柱）恢复到与基线相当的水平。然而，左心室质量指数（132±4；p<0.01）和肱动脉顺应性（1.53±0.01；p<0.01）仍与基线不同。这些结果表明，群多普利的慢性降压治疗与心脏和血管异常的稳定消退有关，这部分与血压降低作用无关。
