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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。
Objective: To investigate the effect of valsartan, an angiotensin Ⅱ receptor antagonist, on arteriolar elasticity in patients with essential hypertension. Methods: Eighty-two patients with essential hypertension were randomly divided into observation group (n = 42) and control group (n = 40). Patients in the observation group received valsartan 80-160 mg · d -1 and control group received hydrochlorothiazide 50-100 mg.d- All oral. Metoprolol (25 mg.d-1) was given in both groups if the blood pressure was not reduced (≤140 / 90 mmHg). Blood pressure, ankle-brachial-ankle pulse wave velocity (ba-PWV) and ankle-brachial index (ABI) were measured by PWV system before treatment and 6 months after continuous treatment. Results: There were no significant differences in systolic blood pressure, diastolic blood pressure, ba-PWV and ABI between the two groups before treatment. After 6 months of treatment, the systolic blood pressure and diastolic blood pressure were significantly decreased in both groups (P <0.05) Systolic blood pressure and diastolic blood pressure had no significant difference between the two groups. The ba-PWV in the observation group was significantly lower than that before treatment and the control group (P <0.01 or P <0.05), and the ABI in the observation group was significantly higher than that before treatment and in the control group <0.01). Conclusion: Compared with hydrochlorothiazide, valsartan can significantly improve arterial elasticity on the basis of the equivalent blood pressure lowering. This improvement may be related to factors other than blood pressure.