血管紧张素转换酶抑制剂对老年高血压左室肥厚患者心率变异性的影响

Effect of angiotensin converting enzyme inhibitor on heart rate variability in the elderly hypertensive left ventricular hypertrophy

目的观察血管紧张素转换酶抑制剂(ACEI)对老年高血压心室肥厚(LVH)和心率变异性(HRV)的影响。方法 71例老年高血压 LVH 者随机分为2组,服用2周安慰剂后分别服用卡托普利(12.5～50 mg,一日二次)和培哚普利(2～8 mg,一日一次)共3个月,于用药前、后测定动脉血压(BP),超声心动图左室质量指数(LVMI)和 HRV 指标。同时测定20例健康老年人 LVMI 和 HRV 指标作为对照。结果两组患者血压均得到良好控制,与对照组相比,71例患者 LVMI 明显增高,HRV 指标明显减低,LVMI 与 HRV 指标呈显著负相关。两组药物抗高血压治疗后 LVMI 降至正常者 HRV 均有明显改善。结论卡托普利和培哚普利可以有效控制老年高血压 LVH 患者的血压,减轻 LVH,其中 LVH 逆转达到正常水平者 HRV 可有明显改善。

Objective To observe the effects of angiotensin converting enzyme inhibitor(ACEI)on left ventricular hypertrophy(LVH)and heart rate variability(HRV)in elderly hypertensive hypertrophy patients(≥60 years).Method Seventy one patients were divided into two groups,eaptopril(12.5～50mg, 2/d)and perindopril(2～8mg,1/d)were taken for three months after two weeks placebo.The blood pres- sure(BP),echo left ventrieular mass index(LVMI)and HRV indexes were measured before and first,sec- ond and third month after the drugs.The same indexes were measured at the same times in twenty healthy elderly persons as the control group.Results The BP were well controlled in both drug groups.Compared with the control group,the LVMI were higher and HRV were lower significantly,the LVMI negatively correlated with HRV indexes in two drug groups.In the patients whose LVMI decreased to normal values after the drug therapy,the decreased HRV indexes improved significantly.Conclusion After antihyper- tensive treatments by eaptopril and perindopril,the LVH in all elderly hypertensive patients decreased and the HRV indexes improved only in those with LVH back to normal values.