Safar M E, Bouthier J A, Levenson J A, Simon A C
Hypertension. 1983 Sep-Oct;5(5 Pt 2):III63-8. doi: 10.1161/01.hyp.5.5_pt_2.iii63.
Since systolic pressure is governed by the rate of ventricular ejection and the rigidity of the aortic wall, antihypertensive agents may have different effects on systolic and diastolic pressure. Despite an adequate decrease in diastolic pressure, systolic pressure may remain elevated due to structural alterations of large arteries. In the present study, a procedure is described to distinguish the dilation of small and large arteries. The former is evaluated from the calculation of forearm resistance and the latter from the determination of the arterial diameter of the brachial artery, using a bidimensional pulsed Doppler system. Nitroglycerin dilates the brachial artery, with no change in forearm resistance. Dihydralazine reduces the diameter of the brachial artery but decreases forearm resistance. Only calcium and converting-enzyme inhibitors dilate both small and large arteries and cause an increase in brachial blood flow.
由于收缩压受心室射血速率和主动脉壁硬度的影响，降压药对收缩压和舒张压可能有不同的作用。尽管舒张压有足够下降，但由于大动脉的结构改变，收缩压可能仍会升高。在本研究中，描述了一种区分小动脉和大动脉扩张的方法。前者通过计算前臂阻力来评估，后者通过使用二维脉冲多普勒系统测定肱动脉的动脉直径来评估。硝酸甘油可使肱动脉扩张，而前臂阻力无变化。肼屈嗪可减小肱动脉直径，但会降低前臂阻力。只有钙通道阻滞剂和血管紧张素转换酶抑制剂能同时扩张小动脉和大动脉，并使肱动脉血流量增加。
