培哚普利、氨氯地平、替米沙坦对血压及臂踝脉搏波传导速度的影响

目的 比较培哚普利、氨氯地平、替米沙坦i种降压药在改善高血压患者动脉弹性功能方而的差异.方法 112例高血压患者被随机分成三个治疗组:培哚普利组38例、氨氯地平组37例、替米沙坦组37例,每组有34例纳入最终统计数据,在服药前和服药1、3个月后应用科林波形分析仪PWV/ABI型仪器测量患者的臂踝脉搏波传导速度(baPWV).结果 (1)降压治疗后所有三组的收缩压、舒张压、脉压均较治疗前明显降低(P<0.001);心率则未见明显变化.(2)baPWV在三组经降压治疗后均有所下降,治疗前培哚普利组、氨氯地平组、替米沙坦组baPWV分别为(1859±492)cm/s、(1780±335)cm/s、(1859±337)cm/s;治疗1个月后培哚普利组、氨氯地平组、替米沙坦组baPWV分别为(1757±508)cm/s、(1647±285)cm/s、(1632±261)cm/s;治疗3个月后培哚普利组、氨氯地平组、替米沙坦组baPWV分别为(1702±538)cm/s、(1559±288)cm/s、(1566±326)cm/s.治疗1个月后与治疗前比较P<0.001;治疗3个月后与治疗前比较P<0.001;治疗3个月后与治疗1个月后比较培哚普利组和替米沙坦组P<0.01,氨氯地平组P<0.001.(3)降压治疗1个月后三组的baPWV均数差值变化及降压治疗3个月后三组的baPWV均数差值变化均为替米沙坦组最大[分别为(227±195)cm/s、(293±243)cm/s],在三组间比较差异有统计学意义(降压治疗1个月后P<0.01,降压治疗3个月后P<0.05).降压治疗3个月后与降压治疗1个月后比三组baPWV均有进一步的下降(P<0.01).结论 (1)本研究结果提示应用培哚普利、氨氯地平、替米沙坦降压均能改善高血压患者动脉弹性功能.(2)降压治疗1个月及3个月时,替米沙坦改善动脉弹性的作用最为明显.(3)血压降至正常并平稳后继续应用培哚普利、氨氯地平、替米沙坦降压治疗对于动脉弹性仍然存在持续的改善作用.

Perindopril, amlodipine and telmisartan improve arterial stiffness in patients with hypertension

Objective To investigate the effect of perindopril, amlodipine and telmisartan on improving the artery stiffness in patients with hypertension. Methods Patients with primary hypertension were randomly assigned to perindopril (4 mg/day), Amlodipine (5 mg/day) and telmisartan (80 mg/day) regimen for 3 months (n=34 each). Brachial-ankle pulse wave velocity (baPWV) was measured by an automatic brachial ankle pulse wave velocity device before the treatment, one-month and three-month after the treatment. Results (1)SBP, DBP and PP were significantly decreased in all three groups (P< 0.001). There were no significant changes in HR in all three groups (P>0.05). ( 2 ) BaPWV was significantly decreased in all three groups, in the perindopril, Amlodipine, telmisartan group,baPWV was (1859±492) cm/s, (1780±335) cm/s, (1859±337) cm/s before the treatment; was (1757±508) cm/s, ( 1647±285) cm/s, (1632±261) cm/s one-month after the treatment; was( 1702±538) cm/s, (1559± 288)cm/s, (1566±326)cm/s three-month after the treatment. Compare the baPWV one-month after the treatment to before the treatment P <0.001 ; Compare the baPWV three-month after the treatment to before the treatment P<0.001 ; Compare the baPWV three-month to one-month after the treatment perindopril group and telmisartan group P<0.01, amlodipine group P<0.001. (3) The changes of baPWV in one or three months were significantly more in the tehnisartan group than in the perindopril and amlodipine groups (1 months P<0.01,3 months P<0.05). The change of baPWV was significantly greater in three months than in one monthin in all three grops (P<0.01 ). Conclusion Arterial stiffness of hypertensive patients was improved post Tehnisartan, amlodipine and perindopril therapy in proportion to therapy duration. Telmisartan is superior to amlodipine and perindopril on improving arterial stiffness of hypertensive patients. Continuous anti-hypertensive treatment with telmisartan, amoodipine and perindopril will have a persistent improvement of the artery flexibility.