不同类型的降压药物对高血压患者脉搏波速度的影响

目的探讨不同类型的降压药物对高血压患者臂一踝脉搏波速度（brachio—anklepulsewavevelocity，baPWV）的影响。方法健康体检首次确诊的高血压患者120例随机分为四组，每组30例，A组（苯磺酸左旋氨氯地平组）、B组（培多普利组）、C组（琥珀酸美托洛尔缓释片组）、D组（缬沙坦组），与正常对照组对比分析血压、血糖、血脂和baPWV的变化。分别给予苯磺酸左旋氨氯地平、培多普利、琥珀酸美托洛尔缓释片、缬沙坦治疗12周后重复测量上述指标，前后对比分析血压和baPWV的变化。结果高血压患者与同期健康体检者对比，收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）和baPWV显著高于正常对照组（P〈0．05）。前述药物治疗12周后，患者SBP、DBP和baPWV显著下降（P〈0．05），苯磺酸左旋氨氯地平收缩压下降幅度（△SBP）（30．6±6．7）mmHgvs（20．7±5．3）mmHg、（19．6±6．1）mmHg、（21.5±4．3nllnHg）和舒张压下降幅度（ADBP）（20．8±7．1）mmHgvs（13．97±7．6）mmHg、（14．1±6．8）mmHg、（14．9±4．2）mmHg明显高于其他三种药物（P〈0．05）。结论常用降压药物可以降低高血压患者的脉搏波速度，改善动脉顺应性。

The effects of various antihypertensive drug treatment on pulse wave velocity in patients with essential hypertension

Objective To evaluate the effects of various antihypertensive drug treatment on Brachialankle pulse wave velocity(baPWV) in patients with essential hypertension.Methods 120 patients with essential hypertension were randomly divided into four group treated various antihypentive drug.Group A 30 cases( levamlodipine besylate 2.5 mg once daily),group B 30 cases(perindopril 4 mg once daily),group C 30 cases ( metoprolol succinate sustained-release tablets 47.5 mg once daily),group D 30 cases(valsartan 80 mg once daily) for twelve weeks and thirty health persons with normal blood pressure as the control group.The levels of serum blood lipid and blood glucose,systolic blood pressures(SBP),diastolic blood pressures(DBP)and baPWV were measured respectively in patients with essential hypertension and healthy persons with normal blood pressure.After twelve weeks treatment respectively,the SDP,DBP and baPWV were measured again and were studied in patients with essential hypertension.Results The level of total blood cholesterol(TC) and low-density lipoprotein cholesterol(LDL-C) and SBP,DBP and baPWV in patients with essential hypertension were higher significantly than that of healthy persons with normal blood pressure(P ＜ 0.05).There were no significant difference in levels of blood glucose in patients with essential hypertension and control group(P ＞ 0.05).The SBP,DBP and baPWV were decreased significantly in all four groups( P ＜ 0.05)after treatment.There were significant difference in reduction of systolic blood pressures(△SBP)(30.6 ± 6.7) mm Hgvs(20.7 ± 5.3) mm Hg、(19.6 ± 6.1) mm Hg 、(21.5 ± 4.3) mm Hg and of diastolic blood pressures(/ DBP)(20.8 ± 7.1) mm Hgvs(13.97 ± 7.6) mm Hg、(14.1 ± 6.8) mm Hg、(14.9 ± 4.2) mm Hg in levamlodipine besylate group and the other three groups(P ＜ 0.05).Conclusion levamlodipine besylate,perindopril,metoprolol succinate sustained-release tablets and valsartan can decreased pulse wave velocity,impore elasticity of large arterise and increase the distensibility of aorta in patients with essential hypertension