Asmar R G, Pannier B M, London G M, Safar M E
Department of Internal Medicine, Broussais Hospital, Paris, France.
J Cardiovasc Pharmacol. 1991;18 Suppl 7:S37-9.
The load of the heart in hypertension is related both to increased peripheral vascular resistance and decreased aortic compliance. From noninvasive studies involving determinations of pulse-wave velocity and systolic-diastolic variations of aortic arch diameter, it can be shown that increased aortic elastic modulus is strongly related to increased cardiac mass. The relationship is observed even after adjustment for the level of mean arterial pressure. It is suggested that decreased aortic compliance in hypertension causes a disproportionate increase in systolic pressure and end-systolic stress, thus contributing to promote cardiac hypertrophy. Such a possibility may have consequences for long-term antihypertensive therapy. Following converting enzyme inhibition and calcium blockade, important dissociations may be observed between the antihypertensive effect and the cardiac and arterial changes.
高血压患者的心脏负荷既与外周血管阻力增加有关，也与主动脉顺应性降低有关。通过涉及脉搏波速度测定和主动脉弓直径收缩期 - 舒张期变化的非侵入性研究表明，主动脉弹性模量增加与心脏质量增加密切相关。即使在调整平均动脉压水平后，这种关系依然存在。有人提出，高血压患者主动脉顺应性降低会导致收缩压和收缩末期应力不成比例地增加，从而促使心脏肥大。这种可能性可能会对长期抗高血压治疗产生影响。在使用转换酶抑制剂和钙通道阻滞剂后，可能会观察到抗高血压作用与心脏和动脉变化之间存在重要的分离现象。
