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血压控制良好的高血压患者循环内皮微粒及臂踝脉搏波速度升高。

Elevated circulating endothelial microparticles and brachial-ankle pulse wave velocity in well-controlled hypertensive patients.

作者信息

Wang J-M, Su C, Wang Y, Huang Y-J, Yang Z, Chen L, Wu F, Xu S-Y, Tao J

机构信息

Department of Hypertension & Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

出版信息

J Hum Hypertens. 2009 May;23(5):307-15. doi: 10.1038/jhh.2008.137. Epub 2008 Nov 27.

Abstract

Vascular dysfunction in hypertensive condition is characterized by impaired endothelial function and reduced artery elasticity. Circulating endothelial microparticles (EMPs) and brachial-ankle pulse wave velocity (baPWV) are novel evaluation parameters for vascular function. However, their changes in patients with well-controlled blood pressure (BP) have not been fully acquired. To address this issue, circulating EMPs, defined as CD31+/CD42- MPs and baPWV were detected in 30 healthy subjects, 30 uncontrolled hypertensive (UCHT) patients and 23 well-controlled hypertensive (WCHT) patients. UCHT patients displayed elevated baPWV (P<0.01) and circulating EMPs (P<0.01) compared with healthy subjects. In WCHT patients, vascular damage represented by these two parameters constantly existed (P<0.01). Values of circulating EMPs were positively related to baPWV (P<0.01). Multivariate regression defined circulating EMPs as an independent contributor to the increase of baPWV value (P<0.05). Our study indicated that though BP was controlled, impaired endothelial function and arterial elasticity continued. The optimal therapy for patients with hypertension should include not only lowering BP but also improvement of vascular injury in parallel.

摘要

高血压状态下的血管功能障碍表现为内皮功能受损和动脉弹性降低。循环内皮微粒(EMPs)和臂踝脉搏波速度(baPWV)是血管功能的新型评估参数。然而,血压控制良好(BP)的患者中它们的变化尚未完全明确。为解决这一问题,对30名健康受试者、30名未控制高血压(UCHT)患者和23名血压控制良好(WCHT)患者检测了定义为CD31+/CD42-微粒的循环EMPs和baPWV。与健康受试者相比,UCHT患者的baPWV(P<0.01)和循环EMPs(P<0.01)升高。在WCHT患者中,以这两个参数表示的血管损伤持续存在(P<0.01)。循环EMPs值与baPWV呈正相关(P<0.01)。多变量回归将循环EMPs定义为baPWV值增加的独立因素(P<0.05)。我们的研究表明,尽管血压得到控制,但内皮功能和动脉弹性受损仍持续存在。高血压患者的最佳治疗不仅应包括降低血压,还应同时改善血管损伤。

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