Ishimitsu Toshihiko, Honda Takeaki, Ohta Satoshi, Akashiba Akira, Takahashi Toshiaki, Kameda Tomoko, Yoshii Masayoshi, Minami Junichi, Takahashi Masaki, Ono Hidehiko, Matsuoka Hiroaki
Department of Hypetension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan.
Am J Hypertens. 2006 Dec;19(12):1233-40. doi: 10.1016/j.amjhyper.2006.05.019.
The objective of this study was to evaluate the effect of year-long antihypertensive therapy with a calcium channel blocker and an angiotensin-converting enzyme (ACE) inhibitor on cardiac and renal injury.
Male 15-week-old spontaneously hypertensive rats (SHR) were given either a normal diet and normal drinking water (n = 10), a diet containing 0.05% nitrendipine (n = 10), or drinking water containing 50 mg/L of quinapril (n = 10). After 12 months of antihypertensive treatment, cardiovascular organ injuries were evaluated.
Tail-cuff blood pressure (BP) at 12 months was significantly lower in animals receiving nitrendipine or quinapril than in control animals (control, 231 +/- 2 mm Hg; nitrendipine, 194 +/- 3 mm Hg; quinapril, 191 +/- 3 mm Hg; P < .001). Furthermore, aortic thickness was reduced by nitrendipine (-19%, P < .001) or quinapril (-21%, P < .001), and cardiac ventricular weight was significantly reduced by quinapril (-18%, P < .001) but not by nitrendipine (-5%, P = not significant [NS]). Echocardiography at 12 months revealed that midwall fractional shortening was higher in the quinapril group than in the control or the nitrendipine groups (control, 9.3% +/- 0.5%; nitrendipine, 9.8% +/- 0.5%; quinapril, 10.6% +/- 0.6%; P < .05). Left ventricular hydroxyproline levels were lower in the nitrendipine group (-21%, P < .01) and the quinapril group (-36%, P < .001) than in the control animals. In control SHR, creatinine clearance began to decrease and proteinuria began to increase at 6 to 9 months. Quinapril but not nitrendipine attenuated these markers of renal impairment (creatinine clearance at 12 months: control, 4.7 +/- 0.4 mL/min/kg; nitrendipine, 5.0 +/- 0.4 mL/min/kg; quinapril, 6.1 +/- 0.4 mL/min/kg; P < .05). Histologically, the glomerular injury score was lower in the quinapril group than in the control or nitrendipine groups (control, 19 [range, 8 to 30]; nitrendipine, 18 [range, 9 to 32]; quinapril, 7 [range, 3 to 12]; P < .01).
It is suggested that year-long antihypertensive therapy with an angiotensin-converting enzyme (ACE) inhibitor is superior to a calcium channel blocker in terms of cardiorenal protection in SHR.
本研究的目的是评估使用钙通道阻滞剂和血管紧张素转换酶（ACE）抑制剂进行为期一年的抗高血压治疗对心脏和肾脏损伤的影响。
将15周龄的雄性自发性高血压大鼠（SHR）分为三组，分别给予正常饮食和正常饮水（n = 10）、含0.05%尼群地平的饮食（n = 10）或含50 mg/L喹那普利的饮水（n = 10）。经过12个月的抗高血压治疗后，评估心血管器官损伤情况。
接受尼群地平或喹那普利治疗的动物在12个月时的尾袖血压（BP）显著低于对照动物（对照组，231±2 mmHg；尼群地平组，194±3 mmHg；喹那普利组，191±3 mmHg；P <.001）。此外，尼群地平（-19%，P <.001）或喹那普利（-21%，P <.001）可使主动脉厚度降低，喹那普利（-18%，P <.001）可使心室重量显著降低，而尼群地平（-5%，P =无显著性差异[NS]）则无此作用。12个月时的超声心动图显示，喹那普利组的室壁中层缩短分数高于对照组或尼群地平组（对照组，9.3%±0.5%；尼群地平组，9.8%±0.5%；喹那普利组，10.6%±0.6%；P <.05）。尼群地平组（-21%，P <.01）和喹那普利组（-36%，P <.001）的左心室羟脯氨酸水平低于对照动物。在对照SHR中，肌酐清除率在6至9个月时开始下降，蛋白尿开始增加。喹那普利可减轻这些肾功能损害指标，而尼群地平则无此作用（12个月时的肌酐清除率：对照组，4.7±0.4 mL/min/kg；尼群地平组，5.0±0.4 mL/min/kg；喹那普利组，6.1±0.4 mL/min/kg；P <.05）。组织学检查显示，喹那普利组的肾小球损伤评分低于对照组或尼群地平组（对照组，19[范围，8至30]；尼群地平组，18[范围，9至32]；喹那普利组，7[范围，3至12]；P <.01）。
在自发性高血压大鼠的心脏和肾脏保护方面，使用血管紧张素转换酶（ACE）抑制剂进行为期一年的抗高血压治疗优于钙通道阻滞剂。
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