Effects of heart rate on arterial compliance in men

1. Arterial compliance is a major determinant of left ventricular afterload. In keeping with earlier experimental data obtained in isolated arterial segments, it has recently been shown in the rat that arterial compliance decreases with an increase in heart rate (HR) induced by atrial pacing. 2. To elucidate the potential relevance of this effect in humans, we investigated nine male volunteers (age 20-30 years; mean 26 years). Systemic arterial compliance (SAC) was measured with the diastolic area method and carotid-to-femoral and femoral-to-dorsalis pedis pulse wave velocities (PWV) were measured to determine regional changes in compliance. Heart rate was first lowered with intravenous metoprolol to 56 +/- 2 b.p.m. and then increased by transoesophageal atrial pacing to 80 and 100 b.p.m. 3. Increasing HR from 56 +/- 2 to 80 b.p.m. by pacing increased mean arterial pressure (MAP) from 78 +/- 2 to 98 +/- 1 mmHg (P < 0.001) and then to 102 +/- 2 mmHg (P = NS). Systemic arterial compliance fell from 0.48 +/- 0.06 to 0.33 +/- 0.04 arbitrary compliance units (ACU; P < 0.01), carotid-to-femoral PWV increased from 6.1 +/- 0.3 to 6.8 +/- 0.4 m/s (P < 0.001) and femoral-to-dorsalis pedis PWV increased from 8.9 +/- 0.4 to 10.1 +/- 0.5 m/s (P < 0.001). Pacing at 100 b.p.m did not change MAP, but did lead to a further decrease in SAC (to 0.24 +/- 0.03 ACU; P < 0.05) and further increases in carotid-to-femoral (7.3 +/- 0.4 m/s; P = NS) and femoral-to-dorsalis pedis PWV (11.3 +/- 0.4 m/s; P < 0.001). 4. We conclude that systemic, central and peripheral compliances decrease in vivo with an increase in HR induced by atrial pacing.     

Correlation of body composition with cardiac function and arterial compliance

1. The aim of the present study was to examine the correlation of precisely measured body composition with cardiac function and arterial compliance. 2. Body composition was determined in a total of 325 healthy volunteers (217 men, 108 women) with an average age of 48 years using bioelectrical impedance analysis (BIA). Multiple body components, such as water, fat, mineral, protein and intracellular and extracellular liquid, were included in our measurements. Aortic pulse wave velocity (PWV) was evaluated to assess arterial stiffness, whereas cardiac function was examined by echocardiography. Levels of serum glucose, high-density lipoprotein-cholesterol, triglycerides, creatinine and uric acid were measured to evaluate the cardiovascular risk of the participants. 3. All parameters of body composition, especially body fat rate (BFR; body fat mass/weight, were closely correlated with arterial function as evaluated by PWV. However, plasma homocysteine, one of the independent risk factors for cardiovascular diseases, failed to exhibit any correlation with arterial compliance. Notably, the BFR was found to be associated with both systolic and diastolic cardiac function with high correlation coefficients. Individuals with normal systolic and diastolic function were characterized with lower PWV values for the aorta, as well as arm and inferior arteries, indicating better arterial compliance. Body fat mass and BFR were significantly lower in subjects with normal systolic function than those with defective arterial compliance. 4. In conclusion, our data provide new insights into the intrinsic correlation between body composition and cardiac function, as well as arterial compliance, implicating a potential application of BIA in the clinical prediction and diagnosis of cardiovascular disease.     

Indices of vascular stiffness and wave reflection in relation to body mass index or body fat in healthy subjects

1. Obesity appears to influence vascular stiffness, an important cardiovascular risk factor. An accurate picture of arterial stiffness may be obtained when a combination of various techniques is used. 2. The purpose of the present study was to assess whether the body mass index (BMI) and body fat content obtained by bioimpedance were of equal value in estimating the influence of body fatness on various indices of vascular stiffness and wave reflection. 3. A total of 175 healthy subjects was studied. Anthropometric measurements and total body bio-impedance analysis were performed to assess fat mass as a proportion of total body composition. Arterial stiffness and wave reflection were assessed using digital volume pulse analysis and tonometric measurement of the wave reflection indices and central haemodynamics. 4. Significant differences in the stiffness index (SI(DVP); P < 0.0001), peripheral augmentation index (pAI(x); P < 0.0001), central augmentation index (cAI(x); P < 0.0001), peripheral pulse pressure (pPP; P = 0.026) and central pulse pressure (cPP; P < 0.0001) were found when the population examined was divided accordingly to tertile of body fat content. However, subdividing various indices of arterial stiffness according to the tertile of BMI did not reveal any significant differences between groups, except for pPP and cPP. 5. Body fat content was significantly correlated with SI(DVP), pAI(x), cAI(x), pPP and cPP. The BMI correlated weakly with SI(DVP), pPP and cPP. 6. In conclusion, the BMI is not very useful in predicting changes in arterial stiffness and wave reflection due to obesity. However, stiffness and wave reflection indices derived from digital volume pulse analysis, the characteristics of radial and aortic pressure waveforms and peripheral and aortic pulse pressure are all related to body fat content, as estimated by bioimpedance.     

Increased cardiovascular risk without generalized arterial dilating diathesis in persons who do not have abdominal aortic aneurysm but who are first‐degree relatives of abdominal aortic aneurysm patients

There is a strong genetic predisposition towards abdominal aortic aneurysm (AAA), but it is unknown whether persons without AAA but with first‐degree relatives who are AAA patients have a generalized dilating diathesis, defect arterial wall mechanics, or increased cardiovascular risk. The aim of the study was to investigate arterial diameters and wall mechanics at multiple arterial sites in these subjects and compare them with controls without a family history of AAA. This study included 118 first‐degree relatives of patients with AAA and 66 controls (age: 40–80 years). The abdominal aorta, common carotid artery, common femoral artery, and popliteal artery were investigated by echo‐tracking ultrasound. The relatives had no arterial dilatation, but they did tend to have smaller diameters than controls. Relatives had a higher heart rate, diastolic blood pressure, and mean arterial pressure than controls. The distensibility coefficient and the compliance coefficient were decreased in all arteries in male relatives, adjusted for age and smoking; these coefficients were normalized after adjustment for mean arterial pressure and heart rate. Female relatives had a lower compliance coefficient in the abdominal aorta, adjusted for age and smoking. After adjustment for mean arterial pressure and heart rate, the difference disappeared. No general arterial dilatation in relatives without AAA was found, supporting the hypothesis that the dilating diathesis is linked to the aneurysmal manifestation in the abdominal aorta. Although the threat of aneurysmal dilatation and rupture seems to be lacking in these subjects, heart rate, blood pressure, and arterial wall stiffness were all increased, which may indicate a higher risk of developing cardiovascular morbidity and mortality.     

Role of Antihypertensive Drugs in Arterial ‘De-Stiffening’ and Central Pulsatile Hemodynamics

Arterial stiffness is an independent predictor of cardiovascular (CV) morbidity and mortality in patients with hypertension, as well as a potential therapeutic target. There is increasing awareness that the pulsatile hemodynamics (central blood pressure [CBP], pulse pressure [PP], wave reflections [augmentation index or AIx] and pulse wave velocity [PWV]) may provide better insight into the pathophysiology of CV disorders and target organ damage related to hypertension. Different antihypertensive drugs produce diverse effects on arterial stiffness variables, despite similar effects on peripheral (brachial) blood pressure. Identifying the pharmacologic interventions that can improve arterial stiffness ('de-stiffening' treatment) is a promising field of research.     

Relationship between occupational exposure to lead and local arterial stiffness and left ventricular diastolic function in individuals with arterial hypertension

Relationship between occupational exposure to lead and frequency of complications in persons with arterial hypertension has been poorly investigated. This study aimed at evaluation of the relationship between occupational exposure to lead and manifestation of an increased local arterial stiffness and left ventricular diastolic dysfunction. The studies included 105 men (mean age: 44.47 ± 9.12 years) with arterial hypertension, treated with hypotensive drugs: group I — men occupationally exposed to lead (n = 53), and group II — men not exposed to lead (n = 52). In echocardiographic examination, the left ventricular diastolic dysfunction was diagnosed significantly more frequently in group I than in group II. In eTracking examination mean values of stiffness parameter (β), augmentation index (AI) and one-point pulse wave velocity (PWV-β) were significantly higher and mean values of arterial compliance (AC) were significantly lower in group I than in group II. The logistic regression showed that in the group of persons with arterial hypertension occupationally exposed to lead a more advanced age, higher blood lead concentration and higher mean values of augmentation index represent independent risk factors of left ventricular diastolic dysfunction. The multifactorial regression showed that amongst persons with arterial hypertension occupationally exposed to lead higher blood zinc protoporphyrin concentration, a more advanced age and higher value of body mass index (BMI) represent independent risk factors of an increased local arterial stiffness. In summary, we should note that in the group of persons with arterial hypertension occupationally exposed to lead the study has demonstrated a significantly more frequent manifestation of left ventricular diastolic dysfunction and an increase in local arterial stiffness.     

长效5-单硝酸异山梨醇酯对健康人血压以及血管弹性功能的动态影响

目的研究长效5-单硝酸异山梨醇酯(抗心绞痛药)对健康人外周动脉血压、中心动脉血压以及血管弹性的动态影响。方法采用自身对照实验设计,18例健康成年男性,早7:00空腹单次给药60 mg;比较服药前1天和服药当天从6:30到23:00期间的血压、脉搏波和心率的变化情况。结果服用5-单硝酸异山梨醇酯后,中心动脉脉压和反射波增加指数均下降,与前1天的基线相比有显著性差异(P<0.05);收缩压和舒张压和心率没有明显变化。结论5-单硝酸异山梨醇酯能明显改善血管顺应性和降低中心动脉脉压。     

ACUTE EFFECTS OF NICOTINE ON ARTERIAL STIFFNESS AND WAVE REFLECTION IN HEALTHY YOUNG NON-SMOKERS

• 1 Recently, we have demonstrated that cigarette smoke exposure proportionally increases plasma nicotine levels and arterial wave reflection to the aorta. However, the exact contribution of nicotine to the smoke‐induced enhancement of wave reflection and the potential underlying mechanisms have not been fully investigated.
• 2 The present study was a prospective study in 15 healthy male non‐smokers. All received a placebo and a 2 mg nicotine tablet, according to a randomized double‐blind cross‐over study design. Each subject underwent repeated measurements at baseline and for 1 h after nicotine or placebo intake, using carotid–femoral pulse wave velocity (PWV) to assess arterial compliance. Concurrently, aortic pressures and the augmentation index were evaluated using applanation tonometry.
• 3 Plasma nicotine concentrations achieved 1 h after intake of the nicotine tablet reached comparable levels to those achieved after 1 h exposure to passive smoke (3.6 ± 0.4 vs 3.2 ± 0.4 ng/mL, respectively; P = 0.4).
• 4 Nicotine enhanced arterial wave reflection to the aorta, as assessed by the augmentation index corrected for heart rate (4.2 ± 1.3 vs–0.7 ± 0.8% with placebo; P = 0.001). In addition, a progressive increase in carotid–femoral PWV was noted after nicotine administration (0.3 ± 0.1 vs–0.02 ± 0.1 m/s with placebo; P = 0.04). This remained significant even after adjustment for changes in mean blood pressure and heart rate (P = 0.01).
• 5 Plasma nicotine concentrations comparable to those achieved after exposure to passive smoke enhance arterial wave reflection to the aorta. This is accompanied by an increase in carotid–femoral PWV, denoting a deterioration of arterial compliance by nicotine.

     

Experimental and clinical study of the combined effect of arterial stiffness and heart rate on pulse pressure: differences between central and peripheral arteries

1. Pulse pressure (PP) constitutes an independent predictor of cardiovascular events and mortality in various populations. Heart rate (HR) and arterial stiffness, in addition to their independent predictive value for cardiovascular complications, seem to interact with regard to the modification of PP. The aim of the present study was to investigate the association of PP with HR under different levels of arterial compliance (AC), revealing their synergistic effects. 2. Seventy-one normotensive and untreated hypertensive subjects were examined. Arterial compliance was measured by the 'area' method, whereas central blood pressures and wave reflections were evaluated using the Sphygmocor system (AtCor Medical, Sydney, NSW, Australia). A hydraulic Windkessel model was also used to evaluate the independent effect of HR and AC on PP. Peripheral PP was associated only with mean pressure and AC. In contrast, central PP was further related to HR (20 b.p.m. decrease in HR resulted in central PP augmentation by 5.6 mmHg) regardless of mean pressure, stroke volume, age and gender. However, this association was statistically significant only for subjects with lower AC (< 1.1 mL/mmHg) and not for those with more compliant arteries. These findings are also in accordance with the experimental data. 3. Aortic PP is affected to a greater degree by HR changes compared with peripheral PP. This response was observed only at high levels of arterial stiffness. 4. The present study provides the first evidence regarding the combined effect of AC and HR on aortic PP, which may lead to larger clinical or epidemiological studies aiming to optimization of drug treatment and to a possible reduction of cardiovascular risk.     

老年高血压患者左室质量与动脉僵硬度关系探讨

摘要目的：探讨老年高血压患者左室肥厚与动脉僵硬度的关系。方法：左室质量指数（LVMI）和脉搏波传导速度（PWV）分别作为评价左室肥厚和动脉僵硬度的指标，对108例老年高血压病患者的LYMI与PWV及其他影响因素之间进行简单相关分析及逐步回归分析。并对不同程度左室肥厚的PWV值进行比较。结果：LYMI与PWV、收缩压、舒张压、脉压、高血压病程、性别及体质量指数呈正相关，与高血压的治疗呈负相关。PWV、高血压治疗、性别和舒张压进入最优回归方程。PWV在左室肥厚者明显高于无左室肥厚者，左室肥厚越明显则PWV越高（F=24．473，P〈0.001）：结论：动脉僵硬度增加是导致老年高血压患者左室肥厚的重要原因。     

EFFECTS OF OESTROGEN AND PROGESTERONE ON AGE-RELATED CHANGES IN ARTERIES OF POSTMENOPAUSAL WOMEN

1. Hormone replacement therapy (HRT) with oestrogen or oestrogen plus progestin may have different effects on arterial structure and function. To examine this question, carotid artery intima-medial thickness (IMT) and indices of systemic and carotid arterial compliance were measured in groups of older men, postmenopausal women not on HRT (non-HRT) and those women on long-term HRT with oestrogen alone (HRT-E) or oestrogen plus progestin (HRT-EP). 2. Sixty men, 90 postmenopausal women taking HRT and 91 not taking HRT participated in the study. The groups were similar for age, body mass index, numbers of smokers, physical activity, alcohol intake and blood pressure. 3. Plasma total cholesterol was reduced and high-density lipo-protein-cholesterol was increased in the HRT group compared with the non-HRT group; low-density lipoprotein-cholesterol, triglyceride and lipoprotein (a) values were similar in these two groups. Results for HRT-E and HRT-EP subgroups were similar. 4. Carotid IMT was significantly reduced in the HRT group compared with men and non-HRT groups. Results for HRT-E and HRT-EP subgroups were similar. 5. Mean systemic arterial compliance (SAC) was significantly greater in men than in women and was related to age; SAC was higher in both HRT-E and HRT-EP groups compared with the non-HRT group. Indices of carotid stiffness were similar in men and in non-HRT groups. The HRT-EP group showed increased carotid stiffness compared with the HRT-E group. 6. There is an apparent protective effect of long-term oestrogen therapy on carotid IMT and age-related changes in arterial stiffness. Progestin does not alter the IMT effects but may adversely influence arterial stiffness.     

Effects of passive smoking on blood pressure and aortic pressure waveform in healthy young adults--influence of gender

AIMS: Passive smoking impairs the elasticity of the aorta in patients with coronary heart disease. We therefore studied the effect of passive smoking on wave reflection in the aorta, a marker of arterial stiffness, in healthy subjects. METHOD: We examined the effects of acute exposure to passive smoking on blood pressure and the aortic pressure waveform in healthy young men (n = 10) and women (n = 11), aged 26 +/- 5 years (mean +/- SEM) compared with 12 healthy controls, aged 24 +/- 2 years (six female) who were exposed to room air. The aortic pressure waveform was derived with radial applanation tonometry (SphygmoCor, AtCor Medical, version 6.2) and the augmentation index, a measure of arterial wave reflection in the aorta, calculated. Blood pressure (Omron Model HEM-705 CP, Omron Corporation, Tokyo, Japan) and augmentation index were measured at baseline, 15, 30 and 60 min after exposure to environmental tobacco smoke (carbon monoxide 25-30 p.p.m. for 60 min) or room air. RESULTS: Passive smoking was associated with an increase in brachial (124 +/- 4-137 +/- 3 mmHg, P < 0.01) and aortic systolic blood pressure (110 +/- 3-123 +/- 4 mmHg, P < 0.01) at 60 min in the male subjects only. The augmentation index increased from -1.7 +/- 5 to 14 +/- 5 at 60 min (P < 0.001) only in the male subjects. The transit time of the pulse did not change significantly. The change in augmentation index was independent of the increase in blood pressure. Brachial and aortic diastolic blood pressure and heart rate did not change significantly in either male or female subjects. No haemodynamic changes were observed in the control group. CONCLUSIONS: Acute exposure to passive smoking has a deleterious effect on the arterial pressure waveform in healthy young males but not in females, suggesting a possible protection of female gender from functional changes in arteries.     

Arterial stiffness and cardiovascular outcome

1. Studies have reported an association between arterial function indices and cardiovascular risk factors, as well as the risk of incident cardiovascular events, including coronary heart disease and stroke. 2. The data are overwhelmingly in favour of an independent role for aortic pulse wave velocity in predicting fatal and non-fatal cardiovascular events in healthy and diseased populations and in the evaluation of cardiovascular risk. 3. Augmentation index may independently predict all-cause mortality and cardiovascular events in coronary and end-stage renal disease patients, but some outcome studies have questioned its usefulness in hypertensive subjects and dialysis patients. 4. Systemic arterial compliance, to this time, has not been shown to independently predict cardiovascular outcome. 5. Future cardiovascular risk is greatly modified by prior disease and risk factors; the greatest additional value in measuring arterial stiffness and compliance may be in those with little or no end-organ disease.     

Association of metabolic syndrome with arterial compliance in children and adolescents

The association of metabolic syndrome (MS) with arterial compliance in children and adolescents was explored. 337 subjects (188 men and 149 women) aged 6–18 (10.95 ± 3.01) years, out of “Beijing Child Metabolic Syndrome Study”, were divided into three case groups (one component, two components, three & more components of MS) and one control group based on the Cook’s MS definition in children and adolescents. Measurements including anthropometry, blood pressure, fasting plasma glucose and insulin, serum lipid profile were done. Homeostasis model assessment for insulin resistance (HOMA-IR) index was calculated for estimating individual insulin resistance. Arterial compliance was measured using digital pulse wave analyzing method from the pulse trace machine (Micro medical, London), and then the stiffness index (SI) was determined. The mean value of SI in MS group was significant higher than that in control group [(7.69 ± 1.63) vs (6.25 ± 0.86) m/s, P<0.01]. With the increase of the clustering of MS components, SI and HOMA-IR were gradually increased. After taking account of gender, age and pubertal development, the partial correlation analysis showed that the amount of components of MS and HOMA-IR were positively correlated with SI (both P values were less than 0.05). The arterial compliance of MS group was significantly lowered in children and adolescents, and with the increase of the clustering of MS components, arterial compliance was gradually decreased. It was suggested that arterial compliance assessment in children and adolescents was important for early prevention of cardiovascular diseases. Translated from Chin J Evid Based Pediatr, 2006, 1(1): 14–19 [译自: 中国循证儿科杂志]     

Different aortic reflection wave responses following long-term angiotensin-converting enzyme inhibition and beta-blocker in essential hypertension

1. In arterial hypertension, aortic wave reflections contribute to determining central systolic and pulse pressures. The present study assessed the central pressure alterations at the level of the common carotid artery following 1 month treatment with perindopril or atenolol and investigated during the 8 h following drug intake. 2. Twenty patients suffering from permanent hypertension were included after a 4 week run-in placebo period in a double-blind, randomized cross-over study comparing the angiotensin-converting enzyme (ACE) inhibitor perindopril with the beta-blocker atenolol during a 4 week treatment period. 3. Before and during the 8 h after drug intake, serial measurements included brachial artery systolic and diastolic blood pressures (SBP and DBP, respectively; mercury sphygmomanometer), carotid artery SBP and pulse pressure (PP; applanation tonometry), aortic pulse wave velocity (Complior; Colson, Les Lilas, France) and arterial wave reflections from the aorta (applanation tonometry; Sphygmocor; PWV Medical, Sydney, NSW, Australia). 4. Both treatments decreased brachial and carotid artery SBP, DBP and PP. Heart rate and pulse wave velocity decreased following atenolol (P < 0.001). Pulse wave velocity was reduced slightly following perindopril (NS). Arterial wave reflections were significantly (P < 0.001) decreased with perindopril in comparison with atenolol, but this effect on wave reflections was not associated with a larger decrease in carotid artery PP. 5. Thus, during chronic treatment, ACE inhibition and selective beta1-adrenoceptor blockade resulted in a similar decrease in brachial and carotid artery PP, but only atenolol reduced heart rate. Aortic pulse wave velocity was reduced with both drugs, but atenolol appeared more effective in improving aortic stiffness. Arterial wave reflections were decreased only following perindopril. 6. Central pulse pressure was improved following 1 month treatment with an ACE inhibitor or beta-adrenoceptor blockade following a decrease in arterial wave reflections with perindopril and a higher decrease in regional aortic stiffness with atenolol.     

Early sex differences in central arterial wave reflection are mediated by different timing of forward and reflected pressure waves

Non‐invasive assessment of central arterial pulse wave augmentation has been proved to be useful in predicting cardiovascular adverse events. Previous studies have shown that pre‐pubescent girls had greater central augmentation pressure compared with height‐matched boys. This study sought to investigate which factors contribute to the body height‐independent sexual differences in central arterial wave reflection observed in childhood. This cross‐sectional study involved 819 children and adolescents (6‐18 years of age) of both sexes. Phenotypes of central haemodynamic were obtained by radial applanation tonometry. Heart rate corrected augmentation index (Aix@75) was greater in girls compared with boys (2.9 ± 10.7 vs ?1.7 ± 12.9%, P < .001) as well as the central augmented pressure (cAP; 1.3 ± 3.3 vs 0.1 ± 3.8 mm Hg, P < .001), even adjusting for age, heart rate and body height. Left ventricular ejection duration (ED) was longer (320 ± 26 vs 314 ± 24 ms, P = .004) and time to inflection point (Tr) was shorter in girls (139 ± 14 vs 141 ± 21 ms, P = .014). The reduction of Aix@75 with increasing body height was steeper in boys (?0.499 ± 0.030 vs ?0.428 ± 0.036%/cm, P < .001) as well as the reduction of cAP with increasing body height (?0.108 ± 0.010 vs ?0.066 ± 0.013 mm Hg/cm, P < .001). Body height‐independent sexual differences observed in the pulse wave reflection indices from early adolescence were mediated by different timing of forward and reflected pressure waves.     

Inhibition of basal nitric oxide synthesis increases aortic augmentation index and pulse wave velocity in vivo

AIMS: To investigate the role of basal nitric oxide (NO) production in regulating large artery stiffness in vivo. METHODS: Incremental doses of the NO synthase inhibitor L-N(G)-monomethyl arginine (LNMMA: 0.1, 0.3, 1.0 and 3.0 mg kg-1 min-1) or placebo were infused in eight healthy men. Arterial stiffness was assessed noninvasively by pulse wave analysis. RESULTS: Compared with placebo, infusion of LNMMA led to a dose-dependent increase in mean arterial pressure, peripheral vascular resistance, and aortic and systemic arterial stiffness. There was an accompanying reduction in heart rate and cardiac index. The highest dose of LNMMA resulted in an increase of 25% in AIx (95% confidence limits; 12, 38) and of 16 mmHg in mean arterial pressure (9, 23) compared with infusion of saline. CONCLUSIONS: These data indicate functional regulation of large artery stiffness in vivo by NO, and may provide new therapeutic strategies for cardiovascular risk reduction.     

Large artery stiffness and antihypertensive agents

Purpose of Review: Since in hypertensive populations, concentration on peripheral blood pressure only does not achieve 100% of blood pressure-attributable risk reduction, taking into consideration other hemodynamic parameters than peripheral blood pressure could perhaps improve cardiovascular prevention. The main purpose of this review is to analyse the scientific data in favour of considering arterial stiffness parameters as interesting intermediate cardiovascular endpoints in order to optimise risk assessment and risk reduction strategies. Summary: Aortic pulse wave velocity (PWV), a marker of aortic stiffness, has been shown to be a strong independent predictor of cardiovascular morbid events, cardiovascular and all-cause mortality in numerous studies in different populations. Furthermore, it has been shown in a therapeutic trial that the lack of aortic PWV attenuation despite significant drug-induced reduction in mean blood pressure was a significant predictor of cardiovascular death in subjects with end-stage renal disease. In essential hypertension, the Reason Study has shown that, despite a similar decrease in peripheral diastolic blood pressure, different effects on central hemodynamic parameters were observed between blockade of the renin-angiotensin system and atenolol. Novel therapeutic approaches available to reduce the increase of pulse pressure and arterial stiffness with age involve converting enzyme inhibitors in association with diuretic compounds; nitrate derivatives; agents acting on collagen cross-linking; and finally spironolactone and vasopeptidase inhibitors. Conclusion: These results support the hypothesis that measurement of aortic PWV could then help, not only in risk assessment strategies but also in risk reduction strategies by monitoring arterial stiffness under different pharmacological regimens.     

局部运动与动脉血压及动脉血管顺应性的相关性研究

目的研究血压正常人群,局部运动与动脉血压及动脉血管顺应性的关系。方法入选高校在校健康学生50名（男生20名,女生30名）,均无吸烟史,父和（或）母均无高血压。受试前保持安静、休息5-10min。分别于运动前、运动后3min即刻及运动后休息10min后心率、双下肢血压及左、右侧脉搏波传导速度（PWV）,比较3次所测观察指栆血压、脉搏波速及心率有无统计学意义。结果运动后即刻测得各项指标与辐动前相比,辐动侧收缩压、舒张压及PWV均无明显变化（P〉0.5、0.05〈P〈0.1和0.4〈P〈0.5）、对侧肢体运动后与运动前相比收缩压有统计学意义（0.02〈P〈0.05）;舒张压及PWV均无明显变化（0.05〈P〈0.1和P〉0.5）。休息10min后双侧收缩压、舒张压均下降（P〈0.05）,PWV明显下降（P〈0.001）且下降程度比运动3min时明显;运动前与运动后即刻及运动后休息10min时的心率相比无明显改变（0.1〈P〈0.2和0.05〈P〈0.1）。结论局部运动可影响动脉血压及血管顺应性。     

血管回声跟踪技术对高脂血症患者颈动脉弹性的研究价值

目的 评价血管回声跟踪技术对高脂血症患者颈动脉弹性的诊断价值.方法 应用血管回声跟踪技术检测51例高脂血症患者及30例对照组正常人双侧颈动脉,获取颈动脉弹性指标,包括颈动脉僵硬度(Ep)、弹性系数(β)、顺应性(AC)、增大指数(AI)及脉搏波传导速度(PwVβ),比较高脂血症患者与正常人颈动脉弹性的差异.结果 高脂血...