Kinouchi Kenichiro, Ichihara Atsuhiro, Bokuda Kanako, Kurosawa Hideaki, Itoh Hiroshi
Department of Endocrinology, Metabolism, and Nephrology, Keio University School of Medicine, Tokyo 160-8582, Japan.
Int J Hypertens. 2011;2011:284823. doi: 10.4061/2011/284823. Epub 2011 Jun 27.
Background/Aims. Arterial stiffness is an independent risk factor for cardiovascular morbidity and mortality. This study was conducted to determine the effect of olmesartan (OLM) and azelnidipine (AZL) on arterial stiffness using the cardio-ankle vascular index (CAVI), which is a novel blood pressure (BP)-independent marker for arterial stiffness in hypertensive patients. Methods. Fifty-two consecutive hypertensive patients were randomly assigned either to a group treated with OLM monotherapy or to a group treated with OLM and AZL combination therapy. Clinical and biological parameters were measured before and 12 months after the start of this study. Results. Both therapies significantly and similarly reduced BP, augmentation index, and plasma aldosterone levels. The combination therapy significantly decreased CAVI and serum low-density lipoprotein (LDL-C) levels and these reductions were significantly greater than those produced with monotherapy. No significant differences in metabolic parameters were observed between the two therapies. Conclusion. The combination therapy with OLM and AZL had beneficial effects on arterial stiffness assessed by CAVI, LDL-C, and metabolism, despite the similar BP reduction, compared with OLM monotherapy. Since these markers are known to influence the future risk of cardiovascular events, combination therapy with OLM and AZL could be a useful choice for treating hypertensive patients.
背景/目的。动脉僵硬度是心血管疾病发病和死亡的独立危险因素。本研究旨在使用心踝血管指数（CAVI）来确定奥美沙坦（OLM）和阿折地平（AZL）对动脉僵硬度的影响，CAVI是高血压患者动脉僵硬度的一种新型血压（BP）独立标志物。方法。52例连续入选的高血压患者被随机分为接受OLM单药治疗组或接受OLM与AZL联合治疗组。在本研究开始前及开始后12个月测量临床和生物学参数。结果。两种治疗均显著且相似地降低了血压、增强指数和血浆醛固酮水平。联合治疗显著降低了CAVI和血清低密度脂蛋白（LDL-C）水平，且这些降低幅度显著大于单药治疗。两种治疗之间在代谢参数方面未观察到显著差异。结论。与OLM单药治疗相比，尽管血压降低程度相似，但OLM与AZL联合治疗对通过CAVI评估的动脉僵硬度、LDL-C和代谢具有有益作用。由于已知这些标志物会影响未来心血管事件的风险，OLM与AZL联合治疗可能是治疗高血压患者的一个有用选择。
