Christensen Marina K, Olsen Michael H, Wachtell Kristian, Tuxen Christian, Fossum Eigil, Bang Lia E, Wiinberg Niels, Devereux Richard B, Kjeldsen Sverre E, Hildebrandt Per, Rokkedal Jens, Ibsen Hans
Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital, University of Copenhagen, Denmark.
Blood Press. 2006;15(4):198-206. doi: 10.1080/08037050600962968.
The aim of this study was to investigate the effects of losartan- vs atenolol-based antihypertensive treatment on circulating collagen markers beyond the initial blood pressure (BP) reduction.
In 204 patients with hypertension and left ventricular (LV) hypertrophy we measured serum concentration of carboxy-terminal telopeptide of type I procollagen (ICTP), carboxy-terminal propeptide of type I procollagen (PICP), amino-terminal propeptide of type III procollagen (PIIINP), amino-terminal propeptide of type I procollagen (PINP) and LV mass by echocardiography at baseline and annually during 4 years of losartan- or atenolol-based antihypertensive treatment; 185 patients completed the study.
Beyond the first year of treatment systolic and diastolic BP, LV mass index (LVMI) as well as collagen markers did not change significantly and were equal in the two treatment groups. Changes in PICP during first year of treatment were related to subsequent changes in LV mass index after 2 and 3 years of treatment (r=0.28 and r=0.29, both p<0.05) in patients randomized to losartan, but not atenolol.
Long-term losartan- vs atenolol-based antihypertensive treatment did not influence collagen markers differently, making a BP-independent effect of losartan on collagen markers unlikely. However, initial reduction in circulating PICP may predict later regression of LV hypertrophy during losartan-based antihypertensive treatment.
本研究旨在探讨基于氯沙坦与阿替洛尔的降压治疗对循环中胶原标志物的影响，该影响超出了初始血压降低的范畴。
在204例高血压合并左心室（LV）肥厚患者中，我们在基线时以及基于氯沙坦或阿替洛尔的降压治疗4年期间每年通过超声心动图测量I型前胶原羧基末端肽（ICTP）、I型前胶原羧基末端前肽（PICP）、III型前胶原氨基末端前肽（PIIINP）、I型前胶原氨基末端前肽（PINP）的血清浓度以及左心室质量；185例患者完成了研究。
在治疗的第一年之后，收缩压和舒张压、左心室质量指数（LVMI）以及胶原标志物均无显著变化，且在两个治疗组中相等。在随机接受氯沙坦而非阿替洛尔治疗的患者中，治疗第一年PICP的变化与治疗2年和3年后左心室质量指数的后续变化相关（r = 0.28和r = 0.29，均p < 0.05）。
基于氯沙坦与阿替洛尔的长期降压治疗对胶原标志物的影响并无差异，这使得氯沙坦对胶原标志物具有不依赖血压的作用不太可能。然而，循环中PICP的初始降低可能预测基于氯沙坦的降压治疗期间左心室肥厚的后期消退。
