Zanchetti A
Istituto di Clinica Medica e Terapia Medica, Università di Milano, Ospedale Maggiore, Italy.
Blood Press Suppl. 1996;4:30-5.
In the ELSA trial, the effects of lacidipine-based treatment and beta-blocker (atenolol)-based treatment on the development and progression of carotid wall alterations are assessed in hypertensive patients. The primary endpoint of this study is the rate of change in the intima-media thickness of the carotid artery wall, measured with B-mode ultrasound. About 2300 hypertensive patients have been recruited and randomized to either of the antihypertensive agents. Baseline data for 1965 patients are available, showing a high prevalence of carotid wall lesions: about 82% of the subjects have an intima-media thickness > or = 1.3 mm, defined as plaque in the ELSA protocol; 16% of the subjects have intima-media thickening (> or = 1.0 mm, < 1.3 mm) and only about 1% have normal carotid artery walls. Analysis of demographic data and risk factor prevalence in ELSA patients, and comparison of these preliminary observations with data from other intervention or observational studies indicate that high blood pressure is a very important risk factor for carotid atherosclerosis.
在ELSA试验中，研究人员评估了以拉西地平为基础的治疗方案和以β受体阻滞剂（阿替洛尔）为基础的治疗方案对高血压患者颈动脉壁病变发生和进展的影响。本研究的主要终点是采用B型超声测量的颈动脉壁内膜中层厚度的变化率。约2300名高血压患者被招募并随机分配至两种降压药物中的一种。现有1965名患者的基线数据，结果显示颈动脉壁病变的患病率很高：约82%的受试者内膜中层厚度≥1.3mm，在ELSA方案中这被定义为斑块；16%的受试者存在内膜中层增厚（≥1.0mm，<1.3mm），只有约1%的受试者颈动脉壁正常。对ELSA患者的人口统计学数据和危险因素患病率进行分析，并将这些初步观察结果与其他干预或观察性研究的数据进行比较，结果表明高血压是颈动脉粥样硬化的一个非常重要的危险因素。
