Barenbrock M, Spieker C, Hoeks A P, Zidek W, Rahn K H
Medizinische Poliklinik, University of Münster, FRG.
Hypertension. 1994 Jan;23(1 Suppl):I161-3. doi: 10.1161/01.hyp.23.1_suppl.i161.
Apart from lowering blood pressure, antihypertensive drugs may influence vessel wall function. In a randomized double-blind study, the effect of lisinopril and metoprolol on arterial distensibility was studied in 40 patients with essential hypertension. After a placebo run-in period, the patients were randomly treated with metoprolol (50, 100, or 200 mg) or lisinopril (5, 10, or 20 mg) for 10 weeks. In the lisinopril group, blood pressure decreased after 10 weeks of therapy from 173 +/- 10/102 +/- 5 to 155 +/- 10/85 +/- 3 mm Hg and in the metoprolol group from 167 +/- 12/102 +/- 4 to 153 +/- 8/84 +/- 3 mm Hg. Diameter (millimeters), relative change in diameter (percent), and distensibility (10(-3)/kPa) of the left common carotid artery were determined after the placebo run-in period and after 6 and 10 weeks of antihypertensive therapy. A multigate Doppler system was used to measure the vessel wall movements by Doppler analysis in M-mode; blood pressure was recorded by finger plethysmography (Finapres). Neither lisinopril nor metoprolol influenced the end-diastolic diameter of the common carotid artery after 6 and 10 weeks of treatment. In the lisinopril group, a significant increase of percent change in diameter (P < .05 compared with the baseline value; P < .05 compared with the metoprolol group) and distensibility (P < .01 compared with the baseline value; P < .05 compared with the metoprolol group) was observed. The results show that lisinopril but not metoprolol improves arterial distensibility in essential hypertension. Pressure-independent effects of angiotensin converting enzyme inhibitors may be important modulators of adaptive changes in the arterial wall.
除了降低血压外，抗高血压药物可能会影响血管壁功能。在一项随机双盲研究中，对40例原发性高血压患者研究了赖诺普利和美托洛尔对动脉扩张性的影响。在经过安慰剂导入期后，患者被随机给予美托洛尔（50、100或200毫克）或赖诺普利（5、10或20毫克）治疗10周。在赖诺普利组，治疗10周后血压从173±10/102±5毫米汞柱降至155±10/85±3毫米汞柱，在美托洛尔组从167±12/102±4毫米汞柱降至153±8/84±3毫米汞柱。在安慰剂导入期后以及抗高血压治疗6周和10周后，测定左颈总动脉的直径（毫米）、直径相对变化（百分比）和扩张性（10⁻³/千帕）。使用多门多普勒系统通过M模式的多普勒分析测量血管壁运动；通过手指体积描记法（Finapres）记录血压。治疗6周和10周后，赖诺普利和美托洛尔均未影响颈总动脉的舒张末期直径。在赖诺普利组，观察到直径变化百分比显著增加（与基线值相比P<0.05；与美托洛尔组相比P<0.05）以及扩张性显著增加（与基线值相比P<0.01；与美托洛尔组相比P<0.05）。结果表明，在原发性高血压中赖诺普利可改善动脉扩张性，而美托洛尔则不能。血管紧张素转换酶抑制剂的压力非依赖性作用可能是动脉壁适应性变化的重要调节因子。
