Stella M L, Failla M, Mangoni A A, Carugo S, Giannattasio C, Mancia G
Cattedra di Medicina Interna I, Università di Milano e Ospedale San Gerardo, Monza, Italy.
Blood Press. 1998 May;7(2):96-102. doi: 10.1080/080370598437466.
Systolic hypertension of the elderly is characterized by a reduction in arterial compliance. Whether and to what extent this involves arteries of various structure and size is not well known.
To study carotid and radial artery compliance in systolic hypertension of the elderly, compared to essential hypertension and normotension.
We investigated 28 elderly patients with systolic hypertension (age 68.6 +/- 1.4 years, mean +/- SE; systolic blood pressure > 160 mmHg and diastolic blood pressure < 90 mmHg) plus 17 age-matched patients with essential hypertension and 15 age-matched healthy normotensive subjects. Radial and carotid artery compliance were evaluated using echotracking techniques. In both arteries compliance was assessed statistically and dynamically, i.e. as compliance values throughout the diasto-systolic pressure range. Measurements included intima-media wall thickness of the radial artery.
Compared to normotensive subjects, carotid artery compliance was reduced in essential hypertension and more so in systolic hypertension. However, although in both groups radial artery wall thickness was markedly greater than in the normotensive group, radial artery compliance was markedly reduced in systolic hypertension, but unchanged in essential hypertension.
In systolic hypertension of the elderly the reduction of arterial compliance is marked in both muscular and large elastic arteries, while in elderly essential hypertensives changes in arterial compliance are more heterogeneous, i.e. only carotid artery compliance is reduced. The different effects of these two types of hypertension on arterial mechanics are visible throughout the physiological range of blood pressure and probably accounted for by different alterations in vessel wall structure.
老年收缩期高血压的特点是动脉顺应性降低。这种情况在多大程度上以及是否涉及各种结构和大小的动脉尚不清楚。
研究老年收缩期高血压患者的颈动脉和桡动脉顺应性，并与原发性高血压和血压正常者进行比较。
我们调查了28例老年收缩期高血压患者（年龄68.6±1.4岁，均值±标准误；收缩压>160 mmHg且舒张压<90 mmHg），另外还有17例年龄匹配的原发性高血压患者和15例年龄匹配的血压正常健康受试者。使用超声跟踪技术评估桡动脉和颈动脉的顺应性。对两条动脉的顺应性进行了静态和动态评估，即在整个舒张-收缩压范围内的顺应性值。测量包括桡动脉内膜中层厚度。
与血压正常者相比，原发性高血压患者的颈动脉顺应性降低，老年收缩期高血压患者降低更明显。然而，尽管两组桡动脉壁厚度均显著大于血压正常组，但收缩期高血压患者桡动脉顺应性显著降低，而原发性高血压患者则无变化。
在老年收缩期高血压患者中，肌性动脉和大弹性动脉的动脉顺应性均显著降低，而在老年原发性高血压患者中，动脉顺应性变化更为不均一，即仅颈动脉顺应性降低。这两种类型的高血压对动脉力学的不同影响在整个血压生理范围内都可见，可能是由血管壁结构的不同改变所致。
