Studies Coordinating Centre, Laboratory of Hypertension, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.
Hypertens Res. 2011 Apr;34(4):489-95. doi: 10.1038/hr.2010.256. Epub 2011 Jan 13.
We investigated the effects of different antihypertensive drugs on the ambulatory arterial stiffness index (AASI), pulse pressure (PP), the arterio-ventricular coupling index (AVCI) and aortic pulse wave velocity (aPWV). After a 4-week placebo period, 94 and 107 patients with uncomplicated hypertension were randomly assigned to treatment with atenolol (AT) at dosage of 50 mg per day or perindopril/indapamide (PER/IND) at dosage of 2/0.6 mg per day for 1 year. From each patient's 24-h ambulatory blood pressure (BP) recording, we determined the 24-h systolic and diastolic BPs. We computed PP as the difference between 24-h systolic and diastolic BP, AASI as unity minus the regression slope of diastolic on systolic BP, and AVCI as (T/τ)/(1+2T/3τ), where T is the heart period in seconds and τ is the decay time of aortic BP during diastole. On AT compared with PER/IND, with adjustments applied for covariables, 24-h systolic BP (-9.5 vs. -13.7 mm Hg; P=0.009) and 24-h PP (-1.02 vs. -6.53 mm Hg; P<0.001) decreased less and AVCI lengthened more (+0.019 vs. -0.008; P<0.001). The changes in AASI (-0.001 vs. -0.014; P=0.44) and aPWV (-0.89 vs. -0.69 m s(-1); P=0.45) were similar in the two treatment groups. AASI and aPWV showed significant concordance (r=0.21, P=0.003) after adjustment for covariables. On administration of antihypertensive drugs with different hemodynamic profiles, AASI and aPWV behaved similarly. The similarity in the findings for aPWV and AASI support the use of AASI as an index reflecting the arterial stiffness.
我们研究了不同降压药物对动态动脉僵硬度指数（AASI）、脉压（PP）、房室偶联指数（AVCI）和主动脉脉搏波速度（aPWV）的影响。经过 4 周的安慰剂期后，94 名和 107 名未经治疗的高血压患者被随机分为每天服用 50mg 阿替洛尔（AT）或每天服用 2/0.6mg 培哚普利/吲达帕胺（PER/IND）治疗 1 年。从每位患者的 24 小时动态血压（BP）记录中，我们确定了 24 小时收缩压和舒张压。我们计算了 24 小时收缩压和舒张压之间的 PP，AASI 为 1 减去舒张压对收缩压的回归斜率，AVCI 为（T/τ）/（1+2T/3τ），其中 T 为秒，τ 为舒张期主动脉 BP 的衰减时间。与 PER/IND 相比，在调整了协变量后，AT 组的 24 小时收缩压（-9.5 对-13.7mmHg；P=0.009）和 24 小时 PP（-1.02 对-6.53mmHg；P<0.001）降低较少，AVCI 延长更多（+0.019 对-0.008；P<0.001）。两组间 AASI（-0.001 对-0.014；P=0.44）和 aPWV（-0.89 对-0.69m/s；P=0.45）的变化相似。在调整协变量后，AASI 和 aPWV 仍具有显著的一致性（r=0.21，P=0.003）。在使用具有不同血流动力学特征的降压药物治疗时，AASI 和 aPWV 的表现相似。aPWV 和 AASI 的结果相似支持使用 AASI 作为反映动脉僵硬度的指标。
