缬沙坦对高血压病的疗效及其对肱动脉内皮功能的影响

Efficacy of valsartan on essential hypertension and its influence on endothelial function of brachial artery

目的 :观察缬沙坦对原发性高血压病人的降压疗效及其对肱动脉内皮功能的影响。方法 :35例高血压病病人 (治疗组 )应用缬沙坦 80mg ,po ,qd× 30wk。 2 2例健康志愿者为对照组。采用多普勒超声血管显象法测定 2组肱动脉血流调节的扩血管反应 (FMD)和硝酸甘油诱发的扩血管反应 (NMD)。结果 :治疗组应用缬沙坦后 2wk显著降压 (P <0 .0 1) ,4～ 6wk进一步降压 ,至 30wk持续平稳降压 (P <0 .0 1) ,降压总有效率 2wk为 5 1% ,30wk达 80 % ;治疗组FMD和NMD显著低于对照组[(6±s 5 ) %vs(18± 7) % ,(17± 9) %vs (2 8±11) % ,P <0 .0 1],治疗组应用缬沙坦后FMD与用药前比较显著提高 (P <0 .0 1) ,但仍低于对照组(P <0 .0 1)。结论 :缬沙坦具有降压和改善FMD ,恢复动脉内皮功能 。

AIM: To observe the effect of valsartan on blood pressure and its influence on endothelial function of the brachial artery in patients with essential hypertension (EH). METHODS: The patients with EH (n=35)were treated with valsartan 80mg, qd, for 30 wk. The blood pressure(BP)was measured every 2-4 wk during 30 wk. In EH group (n=35) and control group (n=22), flow-mediated vasodilation (FMD) and nitrogluperin-induced vasodilation (NMD) in the brachial artery were assessed using high-resolution vascular ultrasonic technique. The patients with EH were examined by ultrasonic technique at the end of treatment. RESULTS: At the end of 2 wk, BP decreased significantly in patients with EH treated with valsartan (P< 0.01), further antihypertensive effect was maintained during 4-6 wk, and BP decreased continuously up to 30 wk. The total hypotensive rate of valsartan was 51 % at 2 wk and 80 % at 30 wk respectively. FMD and NMD in treatment group were significantly lower than those in control group ((6±5) % vs (18±7) %, P< 0.01, and (7±9) % vs (28±11) %, P< 0.05). After administration of valsartan, the im-paired FMD restored ((6±5) % vs (10±3) %, P< 0.01), but was lower than that of control group (P<0.01). CONCLUSION: Valsartan has significant effects on antihypertension, improvement of FMD, restoration of artery endothelium and protection from atherosclerosis.