Bellido Claudio A, Iavicoli Oscar R, Rusak Eduardo J, Vazquez Sonia T, Piñeiro Daniel J, Lerman Jorge
Laboratory of Hypertension, Division of Cardiology, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina.
J Clin Hypertens (Greenwich). 2006 Aug;8(8):555-60. doi: 10.1111/j.1524-6175.2006.05342.x.
Pulse wave velocity is a reliable marker of arterial compliance. Stiffness of large and elastic arteries leads to a faster propagation of pulse wave. The aim of this study was to evaluate changes in arterial distensibility using antihypertensive drugs. This treatment focused on the inhibition of the renin-angiotensin-aldosterone system and the changes produced in blood pressure. Measurements were taken at baseline and throughout 60 months in 66 previously untreated hypertensive patients (22 men and 44 women, aged 54 +/- 9.5 years, range 38-73 years at baseline). All patients received either angiotensin-converting enzyme inhibitors or, in case of adverse effects, angiotensin receptor blockers. To control blood pressure, diuretics, calcium channel blocking agents, or beta blockers were added when appropriate. Statistical analysis was performed by means of ANOVA with alpha = 0.05. Systolic and diastolic blood pressure decreased during the first year without significant changes thereafter. There were no significant changes in pulse pressure. Pulse wave velocity showed a continuous and significant decrease throughout the follow-up period, but its reduction since the third year was more evident than the decrease in systolic and diastolic blood pressure (p < 0.0001 for both). This observation could be related to changes in arterial remodeling probably due to angiotensin-converting enzyme inhibition or renin angiotensin system blockade. Further investigations are needed to establish this relationship.
脉搏波速度是动脉顺应性的可靠指标。大弹性动脉的僵硬会导致脉搏波传播更快。本研究的目的是评估使用抗高血压药物时动脉扩张性的变化。该治疗侧重于抑制肾素 - 血管紧张素 - 醛固酮系统以及血压产生的变化。对66例先前未接受治疗的高血压患者（22名男性和44名女性，年龄54±9.5岁，基线时年龄范围38 - 73岁）在基线时及整个60个月期间进行测量。所有患者接受血管紧张素转换酶抑制剂治疗，若出现不良反应则接受血管紧张素受体阻滞剂治疗。为控制血压，必要时添加利尿剂、钙通道阻滞剂或β受体阻滞剂。采用方差分析进行统计分析，α = 0.05。收缩压和舒张压在第一年下降，此后无显著变化。脉压无显著变化。在整个随访期间，脉搏波速度持续显著下降，但自第三年起其下降比收缩压和舒张压的下降更明显（两者均p < 0.0001）。这一观察结果可能与可能由于血管紧张素转换酶抑制或肾素血管紧张素系统阻断导致的动脉重塑变化有关。需要进一步研究来确定这种关系。
