Asmar R, Benetos A, London G, Hugue C, Weiss Y, Topouchian J, Laloux B, Safar M
Department of Internal Medicine, Broussais Hospital, Paris, France.
Blood Press. 1995 Jan;4(1):48-54. doi: 10.3109/08037059509077567.
Compared with normotensive subjects, untreated hypertensive patients show a decrease of their aortic distensibility. Whether antihypertensive treatment, by reducing blood pressure and changing functional and/or structural abnormalities of the arterial wall, may prevent or reverse the arterial damage due to the accelerated ageing process remains unclear. The objective of the present study was to determine, using a cross-sectional approach, whether aortic distensibility as measured by pulse wave velocity, in treated hypertensive patients whose diastolic blood pressure had been normalised for several months, was significantly improved over that of untreated hypertensive patients.
Carotid femoral pulse wave velocity was measured in 124 normotensive subjects and 388 hypertensive patients. The latter group included 164 treated patients with well controlled diastolic blood pressure and 224 untreated hypertensive subjects. The three groups did not differ in other cardiovascular risk factors.
In each group there was a significant relationship between age and pulse wave velocity. When compared with untreated hypertensives, treated hypertensives with well controlled diastolic blood pressure had significantly lower blood pressure and pulse wave velocity according to age. However, although diastolic blood pressure of well controlled hypertensives was not significantly different from that of normotensive subjects, the aortic distensibility of the controlled hypertensives remained reduced showing two characteristics: a faster increase in pulse wave velocity with age and a negative relationship with HDL-cholesterol.
These results suggest that long-term antihypertensive treatment and control of blood pressure using only diastolic blood pressure criteria may not fully reverse arterial alteration associated with hypertensive vascular disease.
与血压正常者相比，未经治疗的高血压患者主动脉扩张性降低。通过降低血压以及改变动脉壁的功能和/或结构异常，抗高血压治疗是否可以预防或逆转因加速衰老过程导致的动脉损伤仍不清楚。本研究的目的是采用横断面研究方法，确定在舒张压已正常化数月的接受治疗的高血压患者中，通过脉搏波速度测量的主动脉扩张性是否比未经治疗的高血压患者有显著改善。
对124名血压正常者和388名高血压患者测量了颈股脉搏波速度。后一组包括164名舒张压得到良好控制的接受治疗的患者和224名未经治疗的高血压患者。三组在其他心血管危险因素方面无差异。
每组中年龄与脉搏波速度之间均存在显著关系。与未经治疗的高血压患者相比，舒张压得到良好控制的接受治疗的高血压患者根据年龄有显著更低的血压和脉搏波速度。然而，尽管得到良好控制的高血压患者的舒张压与血压正常者无显著差异，但得到控制的高血压患者的主动脉扩张性仍然降低，表现出两个特征：脉搏波速度随年龄增加更快以及与高密度脂蛋白胆固醇呈负相关。
这些结果表明，仅使用舒张压标准进行长期抗高血压治疗和控制血压可能无法完全逆转与高血压血管疾病相关的动脉改变。
