ACEI及ARB对寒冷所致的高血压病人循环系统反应的干预

目的 为了探讨血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）对寒冷所致的高血压病人循环系统反应的影响。方法 111例血压控制稳定的高血压病人分成ACEI治疗、ARB治疗组及对照组3组，观察气温骤降前后血压和心率变化。结果 ①3组病人气温骤降前血压控制均达到目标血压；②气温骤降后，ARB治疗组收缩压、舒张压无明显上升，其余各组收缩压、舒张压均明显上升；心率3组均无明显变化；③与对照组比较，ARB组寒冷所致的收缩压上升幅度明显减少；④与对照组比较，ACEI及ARB组寒冷所致的舒张压上升均轻度减少（P＞0．05），但无统计差异，心率变化亦无差异。结论 ACEI未能有效地阻断高血压病人寒冷所致的循环系统反应，亦不比其它降压药优胜；但ARB能有效地阻断高血压病人寒冷所致的循环系统反应，且明显优胜于其它降压药。

The Influence of ACEI and ARB Treatment on Circulatory Responses to Cold in Hypertensive Patients

Objective The purpose of this study was to determine the influence of ACEI and ARB treatment on circulatory responses to cold in hypertensive patients. Method 111 hypertensive patients were divided into four groups according to the patterns of treatment:ACEI,not ACEI,ARB and not ARB.These selected patients were in steady blood pressure before cold.We studied the changes of blood pressure and heart rate before and after the mean ambient air temperature lower suddenly. Result 1.The blood prcssures of four groups were achieved to the target blood pressure before air temperature lower suddenly. 2.Increase of systolic and diastolic blood pressure was insignificant in ARB group after air temperature lower suddenly.It was significant in the other groups. There was no significant changes in heart rate in all groups. 3.The increase of systolic blood pressure induced by cold was more significant in ACEI than that in the control. 4.The increase of systolic blood pressure induced by cold was decreased significantly in ARB group compared to the controls. 5.The increase of diastolic blood pressure induced by cold were decreased mildly in ACEI and ARB groups compared to the controls.there was no difference in statistics (p>0.05).Also there was on in change in heart rate.Conclusions Our results suggest that ACEI therapy can't block the circulatory response to cold in hypertensive patients.It is not better than other antihypertensive drugs.But ARB therapy can signfifcantly block the circulatory response to cold.Furthermore,it is better than other antihypertensive drugs.