Sharman James E, Marwick Thomas H
Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia.
Indian Heart J. 2010 Sep-Oct;62(5):378-83.
Hypertension is accompanied by generalized adverse vascular functional and structural changes including increased large central artery stiffness. Aortic pulse wave velocity (PWV) is a measure of regional large artery stiffness regarded as the gold standard by expert consensus. Elevated aortic PWV imposes additional left ventricular (LV) workload through increased impedance to flow, and independently correlates with LV systolic and diastolic function, as well as cardiovascular mortality. Traditional antihypertensive drugs do not specifically target wall stiffness of the central arteries, but nonetheless may achieve a decline in aortic PWV by reducing mean arterial pressure and unloading the vessel wall. Beyond medication, regular aerobic exercise combined with sodium restricted diet (such as that advocated by the Dietary Approach to Stop Hypertension [DASH] diet) is probably the most effective way to counteract increased large central artery stiffness. This paper reviews the assessment and clinical implications of arterial stiffness in managing patients with hypertension.
高血压伴有全身性不良血管功能和结构变化，包括中央大动脉僵硬度增加。主动脉脉搏波速度（PWV）是区域大动脉僵硬度的一种测量指标，专家共识将其视为金标准。升高的主动脉PWV通过增加血流阻抗给左心室（LV）带来额外负荷，并与LV收缩和舒张功能以及心血管死亡率独立相关。传统抗高血压药物并非专门针对中央动脉壁僵硬度，但通过降低平均动脉压和减轻血管壁负荷，仍可能使主动脉PWV下降。除药物治疗外，规律的有氧运动结合限钠饮食（如高血压防治饮食法[DASH]所倡导的饮食）可能是对抗中央大动脉僵硬度增加的最有效方法。本文综述了动脉僵硬度在高血压患者管理中的评估及临床意义。
