Heistad D D, Lopez J A, Baumbach G L
Department of Internal Medicine, Veterans Administration Medical Center, Iowa City, Iowa.
Hypertension. 1991 Apr;17(4 Suppl):III7-11. doi: 10.1161/01.hyp.17.4_suppl.iii7.
Several new concepts are reviewed concerning structural and functional changes in atherosclerotic and hypertensive blood vessels. First, in regard to modulation of vascular changes, atherosclerosis appears to progress more slowly during hypotension than during normotension. This finding may have implications for the optimal level of blood pressure. Second, structural "remodeling" of the vessel wall occurs in both atherosclerosis and hypertension. Remodeling helps to preserve the arterial lumen despite intimal proliferation in atherosclerosis. In contrast, remodeling (which differs from vascular hypertrophy) reduces the vascular lumen in chronic hypertension. Third, functional changes impair active vasodilator responses in both atherosclerotic and hypertensive vessels, in part by endothelium-dependent mechanisms. Finally, we propose that leukocytes as well as platelets may be important cellular mediators of spasm in atherosclerotic arteries.
本文综述了一些关于动脉粥样硬化和高血压血管结构与功能变化的新概念。首先，关于血管变化的调节，动脉粥样硬化在低血压状态下的进展似乎比正常血压时更缓慢。这一发现可能对血压的最佳水平具有启示意义。其次，血管壁的结构“重塑”在动脉粥样硬化和高血压中均会发生。在动脉粥样硬化中，尽管内膜增生，但重塑有助于维持动脉管腔。相比之下，重塑（不同于血管肥大）会使慢性高血压患者的血管管腔缩小。第三，功能变化会损害动脉粥样硬化和高血压血管的主动舒张反应，部分是通过内皮依赖性机制。最后，我们提出白细胞以及血小板可能是动脉粥样硬化动脉痉挛的重要细胞介质。
