Agata Jun, Nagahara Daigo, Kinoshita Shuichi, Takagawa Yoshitoki, Moniwa Norihito, Yoshida Daisuke, Ura Nobuyuki, Shimamoto Kazuaki
Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Circ J. 2004 Dec;68(12):1194-8. doi: 10.1253/circj.68.1194.
High pulse wave velocity (PWV) is related to cardiovascular risk in essential hypertension (EHT). It is reported that short-term treatment with an angiotensin II receptor blocker (ARB) decreases PWV, as well as blood pressure (BP), and increases the serum adiponectin, known as an adipocytokine, which has an anti-atherosclerotic effect. However, it is not known whether long-term treatment with ARB prevents the increase in PWV independently of the reduction of BP, and whether adiponectin is related to the chronic effect of ARB on PWV.
In order to examine the short-term effect of ARB on PWV, 9 subjects with EHT had PWV measured before and after treatment with an ARB for 1 month. The treatment significantly reduced PWV and BP. For evaluation of the long-term effect of ARB therapy, 56 consecutive subjects with EHT who were already taking anti-hypertensive drugs other than an angiotensin-converting enzyme inhibitor had their PWV measured. We divided the EHT subjects into 2 groups: (1) the ARB group (EHT treated with an ARB for at least 6 months) and (2) the control group (EHT treated with anti-hypertensive drugs other than an ARB). Although there was no significant difference between the 2 groups in BP, age or body mass index, the PWV value in the ARB group was significantly lower than that in the control group. Moreover, the serum adiponectin concentration in the ARB group was significantly higher than that in the control group.
Long-term treatment with ARB inhibits the progression of arterial stiffness independent of BP reduction. One of the mechanisms may be related to the increased serum adiponectin concentration after treatment with an ARB.
高脉搏波速度（PWV）与原发性高血压（EHT）的心血管风险相关。据报道，使用血管紧张素II受体阻滞剂（ARB）进行短期治疗可降低PWV以及血压（BP），并增加血清脂联素水平，脂联素是一种具有抗动脉粥样硬化作用的脂肪细胞因子。然而，尚不清楚ARB长期治疗是否能独立于血压降低而预防PWV升高，以及脂联素是否与ARB对PWV的慢性影响有关。
为了研究ARB对PWV的短期影响，9名EHT患者在接受ARB治疗1个月前后测量了PWV。治疗显著降低了PWV和BP。为了评估ARB治疗的长期效果，对56名连续的EHT患者进行了PWV测量，这些患者已经在服用除血管紧张素转换酶抑制剂以外的抗高血压药物。我们将EHT患者分为两组：（1）ARB组（接受ARB治疗至少6个月的EHT患者）和（2）对照组（接受除ARB以外的抗高血压药物治疗的EHT患者）。尽管两组在BP、年龄或体重指数方面没有显著差异，但ARB组的PWV值显著低于对照组。此外，ARB组的血清脂联素浓度显著高于对照组。
ARB长期治疗可独立于血压降低抑制动脉僵硬度的进展。其中一个机制可能与ARB治疗后血清脂联素浓度升高有关。
