阿托伐他汀对原发性高血压患者血压及AT1-R水平的影响

【目的】 探讨阿托伐他汀对原发性高血压(EH)患者血压?血脂及血管紧张素Ⅱ 1亚型受体(AT1-R)密度的影响?【方法】 初诊1?2级EH患者140例,按随机数字表分为两组:联合治疗组(AmAt)和单纯降压组(Am),AmAt组每天予氨氯地平5 mg+阿托伐他汀20 mg;Am组每天予氨氯地平5 mg+安慰剂,治疗12周?35例正常健康者为正常对照组(HeaC)?所有参加者于基线及治疗12周后检测血压?血脂及单核细胞AT1-R密度?【结果】 EH患者单核细胞AT1-R密度明显高于健康对照组(P < 0.05);两组患者经12周治疗后血压较基线明显降低,以AmAt组下降更加明显(P < 0.05);Am组血脂改变不明显(P > 0.05),AmAt组总胆固醇水平明显降低(P < 0.05);两组患者单核细胞AT1-R密度较前明显降低,以AmAt组下降更加明显(P < 0.05);AT1-R密度与收缩压?舒张压?总胆固醇水平均呈正相关,相关系数r分别为0.724, 0.636和0.644(P < 0.05);在AmAt组中,血脂正常者经治疗后总胆固醇水平并无显著下降(P > 0.05),但其AT1-R密度显著下降?【结论】 阿托伐他汀有辅助降压作用,可能与其下调EH患者单核细胞表面AT1-R有关,这种作用独立于调脂作用?

Effects of Atorvastatin on Blood Pressure and AngII type 1 Receptor (AT1-R) in Patients with Essential Hypertension

【Objective】To study the effects of atorvastatin on blood pressure, blood lipids and expression of AT1-R receptor on monocytes in patients with essential hypertension. 【Methods】 A total of 140 patients with mild to moderate hypertension were recruited. They were randomly assigned into group Am and group AmAt. The group AmAt was given amlodipine 5 mg /d with atorvastatin 20 mg /d, and group Am was given amlodipine 5 mg /d with placebo of atorvastatin. The therapy was 12 weeks. 35 healthy people were selected as healthy control (Group HeaC). Blood pressure, lipid profile, and AT1-R density on monocytes (percentage of AT1-R positive monocytes) were recorded before and after treatment. 【Results】 The AT1-R density of monocytes in hypertensive patients was obviously higher than that in group HeaC (P < 0.05). Blood pressure in both group Am and AmAt was lowered significantly after the therapy, and it was lower in Group AmAt than that in Group Am (P < 0.05). Lipid profile was not changed significantly after the treatment in Group Am(P > 0.05). Total cholesterol was lowered significantly in Group AmAt (P < 0.05). The AT1-R density was decreased in both Group AmAt and Am, and it was lower in Group AmAt than that in Group Am (P < 0.05). AT1-R density correlated with systolic BP, diastolic BP and total cholesterol positively, and the correlation coefficient were 0.724, 0.636, and 0.644, respectively (P < 0.05). In subgroup of normal cholesterol in Group AmAt, AT1-R density was decreased significantly while the cholesterol level stayed still. 【Conclusion】Atorvastatin can down-regulate the expression of AT1-R on monocytes in hypertensive patients, and has a synergic effect on lowering blood pressure, which may be independent of consequence of lowering cholesterol.