Department of Cardiology, The Center of Health Examination, Qilu Hospital, Shandong University, Jinan, China.
Department of Orthopedics, Provincial Hospital of Shandong, Jinan, China.
J Cell Biochem. 2019 Apr;120(4):5713-5721. doi: 10.1002/jcb.27856. Epub 2018 Oct 26.
Increased arterial stiffness may increase cardiovascular morbidity and mortality. Angiotensin II type 1 receptor blocker losartan is potentially useful in controlling the central blood pressure and arterial stiffness in mild to moderate essential hypertension, while the effects of losartan in aged patients with essential hypertension are not entirely investigated.
The carotid-femoral arterial pulse wave velocity (PWV) was measured in aged patients with essential hypertension.
In a cross-sectional study, PWV value was significantly higher in these old patients with essential hypertension, compared with patients without essential hypertension. Logistic regression analysis indicated that age, hypertension duration, and losartan treatment are risk factors of arterial stiffness. In a perspective study, long-term administration of losartan (50 mg/d) remarkably reduced PWV in aged patients with essential hypertension. In a longitudinal study, PWV is an independent predictor of the occurrence of acute coronary syndrome (ACS) in elderly patients with essential hypertension by using multivariate analysis. Further, the ACS occurrence was reduced by long-term administration of losartan in aged patients with essential hypertension, compared with the old hypertensive patients without taking losartan.
Losartan treatment is a negative risk factor of arterial stiffness and reduces the risk of ACS in aged patients with essential hypertension.
动脉僵硬度增加可能会增加心血管发病率和死亡率。血管紧张素 II 型 1 型受体阻滞剂氯沙坦可能有助于控制轻度至中度原发性高血压患者的中心血压和动脉僵硬度，然而，氯沙坦对老年原发性高血压患者的作用尚未完全研究。
测量了老年原发性高血压患者的颈股动脉脉搏波速度（PWV）。
在一项横断面研究中，与无原发性高血压的患者相比，这些老年原发性高血压患者的 PWV 值明显更高。Logistic 回归分析表明，年龄、高血压持续时间和氯沙坦治疗是动脉僵硬度的危险因素。在一项前瞻性研究中，氯沙坦（50mg/d）的长期给药显著降低了老年原发性高血压患者的 PWV。在一项纵向研究中，通过多变量分析发现，PWV 是老年原发性高血压患者发生急性冠状动脉综合征（ACS）的独立预测因子。此外，与未服用氯沙坦的老年高血压患者相比，氯沙坦治疗可降低老年原发性高血压患者发生 ACS 的风险。
氯沙坦治疗是动脉僵硬度的负风险因素，可降低老年原发性高血压患者发生 ACS 的风险。
