Rassler Beate, Hawlitschek Christina, Brendel Julia, Zimmer Heinz-Gerd
Carl-Ludwig-Institute of Physiology, University of Leipzig, 04103 Leipzig, Germany.
Biomedicines. 2022 Nov 28;10(12):3059. doi: 10.3390/biomedicines10123059.
Numerous studies on the effects of antihypertensive treatment in young spontaneously hypertensive rats (SHRs) have shown that early-onset therapy may effectively reduce their blood pressure (BP) even to normotensive values. In contrast, only a few studies investigated the effects of treatment started at an advanced age. These studies revealed that antihypertensive effects are lower in adult or even in senescent SHRs compared with young SHRs. Even more, prevention of cardiac sequelae of hypertension such as hypertrophy and fibrosis is less effective when treatment starts late in life. Because, in patients, combination therapies with calcium antagonists are favored, we studied the efficacy of a combination therapy with captopril and nifedipine in young and old SHRs. We directly compared the treatment effects on BP as well as on cardiac hypertrophy and remodeling between these two animal cohorts. With antihypertensive treatment, significantly lower BP values were achieved in young SHRs despite a shorter treatment period compared with old SHRs. Although treatment effects on cardiac hypertrophy were greater in old than in young SHRs, cardiac fibrosis was significantly attenuated only in young but not in old SHRs. The results emphasize the value of antihypertensive therapy and particularly accentuate the importance of an early-onset therapy. With respect to problems such as late diagnosis and poor therapy adherence, these results may have great importance for the treatment of human hypertension.
大量关于抗高血压治疗对年轻自发性高血压大鼠(SHRs)影响的研究表明,早期治疗可能有效降低其血压(BP),甚至降至正常血压水平。相比之下,只有少数研究调查了高龄开始治疗的效果。这些研究表明,与年轻SHRs相比,成年甚至衰老的SHRs的抗高血压效果较低。更重要的是,当在生命后期开始治疗时,预防高血压的心脏后遗症如肥大和纤维化的效果较差。因为在患者中,钙拮抗剂联合疗法更受青睐,我们研究了卡托普利和硝苯地平联合疗法对年轻和老年SHRs的疗效。我们直接比较了这两个动物队列中治疗对血压以及心脏肥大和重塑的影响。通过抗高血压治疗,与老年SHRs相比,年轻SHRs尽管治疗期较短,但血压值显著降低。虽然老年SHRs对心脏肥大的治疗效果大于年轻SHRs,但仅年轻SHRs的心脏纤维化得到显著减轻,老年SHRs则没有。结果强调了抗高血压治疗的价值,尤其突出了早期治疗的重要性。对于诸如诊断延迟和治疗依从性差等问题,这些结果可能对人类高血压的治疗具有重要意义。