缬沙坦对原发性高血压患者大动脉弹性的影响

目的:探讨血管紧张素Ⅱ受体拮抗剂缬沙坦对原发性高血压患者大动脉弹性的影响.方法:82例原发性高血压患者随机分成观察组42例和对照组40例,观察组予缬沙坦80 ～ 160 mg·d-1,对照组予氢氯噻嗪50～100 mg·d-1,均口服.如果血压下降不达标(≤140/90 mmHg),则两组均加用美托洛尔(25 mg·d-1).在治疗前及连续治疗6个月后分别应用PWV自动测定系统检测血压、臂-踝脉搏波传导速度(ba-PWV)及踝臂指数(ABI).结果:治疗前两组收缩压、舒张压、ba-PWV、ABI比较无显著差异,治疗6个月后,两组收缩压、舒张压均较治疗前显著下降(P＜0.05),治疗后的收缩压、舒张压两组之间比较无显著差异；观察组ba-PWV显著低于治疗前和对照组(P＜0.01或P＜0.05),观察组ABI显著高于治疗前和对照组(P＜0.01).结论:缬沙坦较氢氯噻嗪在同等降低血压水平的基础上可以明显改善其动脉弹性,这种改善作用可能与降压之外的因素有关.

Effects of Valsartan on Large Artery Elasticity in Patients with Essential Hypertension

Objective:To evaluate the effects of angiotensin Ⅱ receptor antagonist valsartan on large artery elasticity in patients with essential hypertension.Method:Eighty two cases of patients with essential hypertension were randomly divided into observation group(42 cases) and control group(40 cases),the observation group was given valsartan(80-160 mg·d-1) treatment,the control group was given hydrochlorothiazide(50-100 mg·d-1) treatment,to plus metoprolol(25 mg·d-1) if blood pressure control did not meet standards(≤140/90 mmHg)in both groups,blood pressure,arm-ankle pulse wave velocity(ba-PWV)and ankle-brachial index(ABI) were applied by automatic measurement system before treatment and 6 months after treatment.Result:Before treatment,systolic blood pressure,diastolic blood pressure,ba-PWV,ABI in both groups showed no significant difference.It was comparable between the two groups.After 6 months treatment,systolic blood pressure,diastolic blood pressure in both groups of patients were decreased significantly than before treatment(P<0.05),with no significant difference between the two groups.The ba-PWV in the observed group was significantly lower than that before treatment and the control group(P<0.01,P<0.05).ABI in the observed group was significantly higher than that before treatment and the control group(P<0.01).ba-PWV,ABI in the control group was no significant change than that before treatment.Conclusion:Valsartan can significantly improve arterial elasticity compared with hydrochlorothiazide at the same level on the basis of lower blood pressure,and this improvement might be also associated with factors other than treatment of hypertension.