高血压患者心脏及大动脉结构和功能改变及降压治疗的效应

Effect of Antihypertensive Therapy on Cardiac and Large Arterial Structural and Functional Change in Essential Hypertensive Patients

目的 评价原发性高血压患者心脏和大动脉结构和功能的改变及硝苯地平控释片 12周治疗的影响。方法 应用二维和多普勒超声及PWV自动测定系统观察 16例进行硝苯地平控释片治疗的原发性高血压患者 ,其中 ,男 12例 ,女 4例 ,平均年龄 6 0 2 5± 8.0 5岁。分别在治疗前和治疗 12周后重复进行上述检测。结果 收缩压、舒张压、平均压、脉压、颈动脉 -股动脉PWV、颈总动脉内膜 -中层厚度、左心室室间隔厚度、左室后壁厚度、左室相对厚度、左室重量指数在治疗 12周后明显降低 ;颈总动脉横断面顺应性、容积扩张性在治疗 12周后显著增加。结论 硝苯地平控释片对心血管系统的影响不仅与血压降低有关 ,同时能明显逆转血管重构 ,改善改善大动脉扩张性和顺应性 ,逆转左室肥厚。

Objective To evaluate the cardiac and large arterial structural and functional change and the effect of nifedipine GITS in patients with essential hypertension. Methods The study population consisted of 16 essential hypertensive patients,12 male and 4 female,mean age 60 25±8.05 years. All patients underwent following examinations, echocardiography, ultrasonographic examination of the common carotid artery and brachial artery, measurement of carotid femoral and brachial radial pulse wave velocity(PWV). All examinations were performed before and 12 weeks after the nifedipine GITS treatment. Results 12 weeks treatment with nifedipine GITS can significantly reduce systolic blood pressure( P= 0 0003), diastolic blood pressure( P= 0 0447), mean blood pressure( P= 0 0014), pulse pressure( P= 0 0222),carotid femoral PWV( P= 0 0030), common carotid artery intima media thickness( P= 0 0232), left ventricular interventricular septal thickness( P= 0 0031), left ventricular posterior wall thickness( P= 0 0012), relative left ventricle thickness( P= 0 0176) and left ventricular mass index( P= 0 0069),respectively. Cross sectional compliance and volumic distensibility of common carotid artery were significantly increased( P= 0 0294, P= 0 0334). Conclusion Nifedipine GITS can not only control blood pressure, but also reverse left ventricular hypertrophy and arterial remodeling,improve large arterial distensibility and compliance in patients with essential hypertension.