Van Bortel L M, Spek J J
Department of Pharmacology, Cardiovascular Research Institute Maastricht, Maastricht University, The Netherlands.
J Hum Hypertens. 1998 Sep;12(9):583-6. doi: 10.1038/sj.jhh.1000669.
With aging, pulse pressure increases. A high pulse pressure has been recognised as an important cardiovascular risk factor. The increase in pulse pressure with aging is mainly due to a decrease in large artery compliance. Compliance and distensibility are large artery wall properties. Compliance is the buffering capacity of the vessel. Distensibility reflects much more the elasticity of the artery. Compliance is related to distensibility and arterial diameter. These large artery wall properties can be measured non-invasively using new echo-tracking techniques. With these techniques it has been shown that the elasticity (distensibility) and the buffering capacity (compliance) of the common carotid artery is decreasing with aging, while diameter of the artery increases. This increase in diameter might be a compensating mechanism to limit the decrease in compliance. There are indications that the effect of aging on large artery wall properties may not be similar at all vascular territories. A decrease in compliance leads to a high pulse pressure and isolated systolic hypertension. The drug of choice for the treatment of isolated systolic hypertension should increase large artery compliance with no, or only minor effect on resistance vessels. This would lead to a decrease in pulse pressure without decreasing mean blood pressure. As a result, systolic but not diastolic blood pressure decreases. It appears that nitrates better than other anti-hypertensive drugs can decrease pulse pressure. They therefore have been advocated for the treatment of isolated systolic hypertension.
随着年龄增长，脉压升高。高脉压已被公认为一种重要的心血管危险因素。脉压随年龄增长主要是由于大动脉顺应性降低。顺应性和扩张性是大动脉壁的特性。顺应性是血管的缓冲能力。扩张性更多地反映了动脉的弹性。顺应性与扩张性及动脉直径相关。这些大动脉壁特性可用新的回声跟踪技术进行无创测量。利用这些技术已表明，颈总动脉的弹性（扩张性）和缓冲能力（顺应性）随年龄增长而降低，而动脉直径增加。直径的增加可能是一种补偿机制，以限制顺应性的降低。有迹象表明，衰老对大动脉壁特性的影响在所有血管区域可能并不相同。顺应性降低会导致高脉压和单纯收缩期高血压。治疗单纯收缩期高血压的首选药物应增加大动脉顺应性，而对阻力血管无影响或仅有轻微影响。这将导致脉压降低而不降低平均血压。结果，收缩压而非舒张压降低。似乎硝酸盐类药物比其他抗高血压药物能更好地降低脉压。因此，它们已被提倡用于治疗单纯收缩期高血压。
