Ljubljana University Medical Centre, University of Ljubljana, Korytkova 2, Ljubljana, Slovenia.
Eur J Prev Cardiol. 2012 Dec;19(6):1243-9. doi: 10.1177/1741826711423104. Epub 2011 Sep 20.
Functional and morphological arterial wall impairment progresses with ageing. Angiotensin II in the arterial wall is involved in this process. Appropriate early intervention might theoretically slow the progress of age-related changes. Herein, we investigated a new approach to this issue: whether arterial wall changes present in middle-aged males could be reduced by low-dose valsartan intervention.
Forty apparently healthy, middle-aged males (42.9 ± 0.9 years) were recruited for a double-blind randomized study and received either placebo or valsartan (20 mg daily) for 30 days. Brachial artery flow-mediated dilation (FMD), pulse wave velocity (PWV), and β-stiffness of the common carotid artery were measured using an Aloka alfa-10 Prosound with an integrated eTracking system at inclusion, after 30 days, and after 3 and 8 months.
Intervention resulted in FMD increase (154.2 ± 20.1 %; p < 0.001) and PWV and β-stiffness decrease compared to initial values (-6.9 ± 1.0 % and -13.2 ± 1.4 %; both p < 0.01) whereas values in the untreated group (p < 0.001 for all parameters) remained unchanged throughout the study. The advantageous effects decreased over the months following valsartan discontinuation, but were still significant after 3 months (largely in FMD and less in PWV and β-stiffness), and negligible after 8 months. The beneficial effects were ascribed to valsartan's pleiotropic effects, as no blood pressure changes were recorded.
We showed that age-related arterial wall changes in middle-aged males are reversible and could be reduced by a low-dose, short-term valsartan intervention. The new approach merits detailed investigation in future studies.
功能和形态学的动脉壁损伤随年龄增长而进展。血管紧张素 II 在动脉壁中参与这一过程。理论上，适当的早期干预可能会减缓与年龄相关的变化的进展。在此，我们研究了一种新的方法：通过低剂量缬沙坦干预是否可以减少中年男性的动脉壁变化。
招募了 40 名看似健康的中年男性（42.9±0.9 岁）进行双盲随机研究，他们分别接受安慰剂或缬沙坦（每天 20 毫克）治疗 30 天。在纳入时、30 天后以及 3 个月和 8 个月时，使用配备集成 eTracking 系统的 Aloka alfa-10 Prosound 超声仪测量肱动脉血流介导的扩张（FMD）、脉搏波速度（PWV）和颈总动脉 β 硬度。
与初始值相比，干预导致 FMD 增加（154.2±20.1 %；p<0.001），PWV 和 β 硬度降低（分别为-6.9±1.0 %和-13.2±1.4 %；均 p<0.01），而未接受治疗的组（所有参数均 p<0.001）在整个研究过程中保持不变。缬沙坦停药后几个月，有利影响逐渐减弱，但停药 3 个月后仍有显著影响（主要在 FMD，PWV 和 β 硬度影响较小），停药 8 个月后影响可忽略不计。这些有益的影响归因于缬沙坦的多效作用，因为没有记录到血压变化。
我们表明，中年男性与年龄相关的动脉壁变化是可逆的，可以通过低剂量短期缬沙坦干预来减少。这种新方法值得在未来的研究中进行详细研究。
