肾素-血管紧张素系统阻断后高血压患者的内皮血管功能
Endothelial vascular function in hypertensive patients after renin-angiotensin system blockade.
作者信息
Souza-Barbosa Leoní Adriana, Ferreira-Melo Sílvia E, Ubaid-Girioli Samira, Arantes Nogueira Eduardo, Yugar-Toledo Juan Carlos, Moreno Heitor
机构信息
Laboratory of Cardiovascular Pharmacology and Hypertension, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
出版信息
J Clin Hypertens (Greenwich). 2006 Nov;8(11):803-9; quiz 810-1.
It is unclear whether single and combined pharmacologic inhibition of the renin-angiotensin-aldosterone system have similar effects on endothelial function and blood pressure (BP). The authors evaluated 63 hypertensive patients divided into 4 groups (hydrochlorothiazide 25 mg/d; irbesartan [IRBE] 150 mg/d; quinapril [QUIN] 20 mg/d; or IRBE 150 mg/d + QUIN 20 mg/d) and 25 healthy normotensive subjects (normal) followed for 12 weeks. Endothelium-dependent dysfunction measured as flow-mediated dilation at Weeks 0 and 12 were: normal, 11.5%+/-2.4% vs 13.5%+/-2.0%; hydrochlorothiazide, 7.3%+/-2.0% vs 12.8%+/-3.1%; QUIN, 7.2%+/-2.8% vs 13.2%+/-2.1%; IRBE, 7.1%+/-2.8% vs 13.0%+/-2.9%; and IRBE + QUIN, 7.5%+/-1.9% vs 12.8%+/-3.0%. Nitroglycerin-mediated responses were: normal, 26.0%+/-1.9% vs 24.0%+/-2.5%; hydrochlorothiazide, 17.0%+/-2.2% vs 18.3%+/-2.6%; QUIN, 17.8%+/-3.2% vs 23.4%+/-3.0%; IRBE, 16.8%+/-3.6% vs 24.7%+/-2.0%; and IRBE + QUIN, 17.3%+/-3.0% vs 25.1%+/-2.5%. Antihypertensive therapy restored BP to normal and improved the endothelium-dependent and -independent dysfunction after renin-angiotensin-aldosterone system blockade. In a further finding, the combined effect of angiotensin-converting enzyme inhibition and angiotensin II type 1 receptor blockade was not superior to the action of either of these treatments separately.
肾素-血管紧张素-醛固酮系统的单一和联合药物抑制对内皮功能和血压（BP）是否具有相似的作用尚不清楚。作者评估了63例高血压患者，分为4组（氢氯噻嗪25mg/d；厄贝沙坦[IRBE]150mg/d；喹那普利[QUIN]20mg/d；或IRBE 150mg/d + QUIN 20mg/d），并对25名健康的血压正常受试者（正常组）进行了为期12周的随访。在第0周和第12周时，以血流介导的扩张来衡量的内皮依赖性功能障碍情况如下：正常组，11.5%±2.4%对13.5%±2.0%；氢氯噻嗪组，7.3%±2.0%对12.8%±3.1%；QUIN组，7.2%±2.8%对13.2%±2.1%；IRBE组，7.1%±2.8%对13.0%±2.9%；IRBE + QUIN组，7.5%±1.9%对12.8%±3.0%。硝酸甘油介导的反应情况如下：正常组，26.0%±1.9%对24.0%±2.5%；氢氯噻嗪组，17.0%±2.2%对18.3%±2.6%；QUIN组，17.8%±3.2%对23.4%±3.0%；IRBE组，16.8%±3.6%对24.7%±2.0%；IRBE + QUIN组，17.3%±3.0%对25.1%±2.5%。肾素-血管紧张素-醛固酮系统阻断后，降压治疗使血压恢复正常，并改善了内皮依赖性和非依赖性功能障碍。进一步的研究发现，血管紧张素转换酶抑制和血管紧张素II 1型受体阻断的联合作用并不优于单独使用这两种治疗方法中的任何一种。
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