Asmar R G, Benetos A, Darne B M, Pauly N C, Safar M E
Department of Internal Medicine, Broussais Hospital, Paris.
J Hum Hypertens. 1992 Oct;6(5):381-5.
In this study the dose-response curves reflecting the arterial and the antihypertensive effects of converting enzyme inhibition were analysed. The BP measurement (using a random zero sphygmomanometer) and its decrease following converting enzyme inhibition were used as a marker of the arteriolar effect of the drug. The effect on conduit arteries was evaluated through determination of carotid-femoral pulse wave velocity used as an index of arterial distensibility. We compared the dose-response curves of these two parameters in a double-blind study carried out in 24 patients with essential hypertension, who were randomised between placebo and 2, 4 and 8 mg of the converting enzyme inhibitor trandolapril given for 8 days. The antihypertensive effect was observed from 2 mg, at which dose the plateau of BP reduction was already achieved. No significant correlation was found between dose and BP reduction (r = -0.34), whereas the dose was significantly related to the change in pulse wave velocity (r = -0.56, P < 0.01). No significant correlation was found between changes in BP and change of pulse wave velocity. The study provides evidence that the effect on the conduit artery was obtained for higher doses than the BP effect in patients treated for hypertension by the converting enzyme inhibitor trandolapril.
在本研究中，对反映转换酶抑制的动脉和降压作用的剂量反应曲线进行了分析。血压测量（使用随机零点血压计）及其在转换酶抑制后的下降被用作药物小动脉效应的标志物。通过测定作为动脉扩张性指标的颈股脉搏波速度来评估对传导动脉的影响。在一项双盲研究中，我们比较了这两个参数的剂量反应曲线，该研究纳入了24例原发性高血压患者，他们被随机分为接受安慰剂以及2毫克、4毫克和8毫克转换酶抑制剂群多普利治疗8天的组。从2毫克开始观察到降压作用，在此剂量时已达到血压降低的平台期。未发现剂量与血压降低之间存在显著相关性（r = -0.34），而剂量与脉搏波速度的变化显著相关（r = -0.56，P < 0.01）。未发现血压变化与脉搏波速度变化之间存在显著相关性。该研究提供了证据，表明在接受转换酶抑制剂群多普利治疗高血压的患者中，对传导动脉的影响所需剂量高于降压作用所需剂量。
