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动脉僵硬度与药物干预——超越动脉僵硬度子研究(TRANS研究)

Arterial stiffness and pharmacological interventions--the TRanscend arterial stiffNess Substudy (TRANS study).

作者信息

Topouchian Jirar, El Feghali Ramzi, Pannier Bruno, Wang Shuyu, Zhao Feng, Smetana Karel, Teo Koon, Asmar Roland

机构信息

The CardioVascular Institute, Paris, France.

出版信息

Vasc Health Risk Manag. 2007;3(4):381-7.

Abstract

The degree of arterial stiffness is correlated with the risk of cardiovascular diseases and it is a powerful predictor for morbidity and mortality. Studies have shown that arterial stiffness reduction is associated with an improvement in survival. Reduction of arterial stiffness by pharmacological drugs varies according to the drugs and doses used and duration of treatment. This effect on the arteries differs among the various classes of drugs and among individual drugs in the same class. Quantification of the stiffness and other properties of the arterial wall can be used to monitor the responses to therapy in individuals with hypertension and other cardiovascular diseases. These measures can then be used as surrogate markers for the risk of clinical events. Inhibition of the renin-angiotensin system (RAS) is associated with an important decrease in cardiovascular risk. Findings from clinical trials support the hypothesis that the protective effects of RAS inhibition are partly independent from blood pressure reduction and related to several mechanisms including vascular protective effects. The aim of the TRanscend Arterial stiffNess Substudy (TRANS) is to assess the effect of an angiotensin II receptor blocker (ARB), telmisartan, on the arterial stiffness in a subgroup of patients from the Telmisartan Randomized Assessment Study in aCE iNtolerant subjects with cardiovascular Disease (TRANSCEND) trial. The TRANSCEND trial is an international, multicenter, randomized double blind placebo controlled trial oftelmisartan that enrolled patients at high risk for cardiovascular events. Some clinical baseline data of the TRANS substudy are reported. When completed, the results of the TRANS substudy will show whether the beneficial effects of treatment with telmisartan on cardiovascular outcome may be related to an improvement in arterial stiffness.

摘要

动脉僵硬度与心血管疾病风险相关,是发病率和死亡率的有力预测指标。研究表明,降低动脉僵硬度与生存率提高有关。通过药物降低动脉僵硬度的效果因所用药物、剂量及治疗持续时间而异。这种对动脉的作用在不同类别的药物以及同一类别的不同药物之间存在差异。对动脉壁僵硬度及其他特性进行量化,可用于监测高血压和其他心血管疾病患者对治疗的反应。这些测量结果随后可作为临床事件风险的替代指标。抑制肾素 - 血管紧张素系统(RAS)与心血管风险的显著降低相关。临床试验结果支持这样的假设,即RAS抑制的保护作用部分独立于血压降低,且与包括血管保护作用在内的多种机制有关。超越动脉僵硬度子研究(TRANS)的目的是评估血管紧张素II受体阻滞剂替米沙坦对替米沙坦在心血管疾病(TRANSCEND)试验中不耐受ACE抑制剂的受试者的随机评估研究中一组患者的动脉僵硬度的影响。TRANSCEND试验是一项关于替米沙坦的国际多中心随机双盲安慰剂对照试验,纳入了心血管事件高风险患者。报告了TRANS子研究的一些临床基线数据。完成后,TRANS子研究的结果将显示替米沙坦治疗对心血管结局的有益作用是否可能与动脉僵硬度的改善有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a89c/2291337/d8c82e16eaf9/vhrm0304-381-01.jpg

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