缬沙坦对高血压患者大动脉硬化和左室肥厚的影响

Effects of valsartan on atherosclerosis of large arteries and left ventricular hypertrophy in hypertensive patients

目的探讨缬沙坦对高血压病患者大动脉硬化及左室肥厚的影响。方法将高血压病患者随机分为缬沙坦治疗组和非洛地平组治疗组(各50例),另设年龄、性别与之匹配的正常人作为对照组(n=50)。用高分辨超声技术检测各组对象的颈动脉平均内中膜厚度、颈动脉斑块发生率、Crouse积分及心脏超声。对缬沙坦组,非洛地平组分别在治疗3个月、1年后复查血压和心脏血管超声的上述指标。结果与对照组比较,缬沙坦组与非洛地平组颈动脉内中膜增厚逆转(P<0.05),左室肥厚改善。缬沙坦组与非洛地平组在降低血压方面作用相同,无显著差异(P>0.05),但缬沙坦组在逆转左室肥厚、逆转颈动脉内中膜厚度、降低新的粥样斑块发生率方面优于非洛地平组(P<0.05)。结论缬沙坦除能有效降低高血压病患者的血压外,还能逆转心脏和大动脉结构异常,延缓动脉粥样硬化进展。

Objective To investigate the effect of treatment with valsartan on atherosclerosis of large arteries and left ventricular hypertrophy in hypertensive patients. Methods The patients with hypertension were randomly divided into group A(treatment with valsartan,n=50)or into group B (treatment with felodipine, n=50).The health subjects work as group C (controls group,n=50),whose age and sex were matched with group A ,B and C.The carotid arterial mean intima—medial thickness(MIMT)and carotid plaques and left ventricular structure were measured with high resolution ultrasonography. Each group above indices and blood pressure were measured again after 3 months and 1 year. Results Compared with group C, group A and B had thinner carotid MIMT(P<0.05), left ventricular hypertrophy were decreased(P<0.05).There was no difference in reduction of blood pressure(P>0.05),Compared with group B and group A had a significantly better effect on decreasing carotid MIMT and decreasing left ventricular hypertrophy and decreasing incidence of new plaques (P<0.01). Conclusion In addition to reduction of blood pressure,valsartan has good effect on regression of abnormal function and structure of large arteries,which may delay the progression of atherosclerosis,reverse the left ventricular hypertrophy.