Simon A, Levenson J, Bouthier J, Maarek B, Safar M
Arch Mal Coeur Vaiss. 1985 Oct;78(11):1720-4.
The non invasive investigation of the brachial artery was performed in 51 mild to moderate essential hypertensive patients and 23 normal subjects of similar age. It included quantitative evaluation of arterial diameter (pulsed Doppler velocimetry), pulse wave velocity (strain gauge mechanography) and arterial compliance deduced from the former indices. Hypertensive patients exhibited higher pulse wave velocity (Pw 0.001) and arterial diameter (p less than 0.01) than normal controls. The strong correlation found in normal subjects between pulse wave velocity and the product of age and diastolic pressure (r = 0.88, p less than 0.001) was used as a nomogram for the analysis of those hypertensive arterial changes. Accordingly the projection of patients on this nomogram enables to distinguish two groups according to that pulse wave velocity was inside (Group 1) (37 patients) or above (Group II) (34 patients) the upper limit of the nomogram. The comparison of these two groups of hypertensive patients showed that despite a similar level of age and pressure, arterial compliance was lower and pulse pressure higher in Group II than in Group I. These results demonstrate that early alterations of brachial artery occur in hypertension: these arterial changes can be attributed in most of the patient to the exclusive effect of aging and pressure elevation; however, in some patients additional degenerative process, perhaps atherosclerotic in nature, is responsible for profound decrease in arterial compliance and increase in pulse pressure so that such patients may appear as especially predisposed to systolic hypertension and degenerative arterial complications.
对51例轻度至中度原发性高血压患者和23例年龄相仿的正常受试者进行了肱动脉的无创性检查。检查内容包括动脉直径的定量评估(脉冲多普勒测速法)、脉搏波速度(应变仪机械记录法)以及根据前两项指标推算出的动脉顺应性。高血压患者的脉搏波速度(Pw<0.001)和动脉直径(p<0.01)均高于正常对照组。正常受试者中脉搏波速度与年龄和舒张压乘积之间的强相关性(r = 0.88,p<0.001)被用作分析这些高血压动脉变化的列线图。因此,将患者的数据投影到该列线图上,能够根据脉搏波速度是在列线图上限以内(第一组)(37例患者)还是高于上限(第二组)(34例患者)区分出两组。对这两组高血压患者的比较显示,尽管两组患者年龄和血压水平相似,但第二组的动脉顺应性低于第一组,脉压高于第一组。这些结果表明,高血压患者肱动脉早期发生改变:这些动脉变化在大多数患者中可归因于衰老和血压升高的单独作用;然而,在一些患者中,额外的退行性过程,可能本质上是动脉粥样硬化,导致动脉顺应性显著降低和脉压升高,因此这些患者可能特别易患收缩期高血压和动脉退行性并发症。