卡维地洛改善高血压患者的血管内皮功能

Improvement of vascular endothelial function by carvedilol in patients with essential hypertension

目的 :探讨卡维地洛对原发性高血压患者血管内皮功能的影响。方法 :用高分辨率超声检测经美托洛尔或卡维地洛治疗 12wk前后的高血压患者肱动脉流量介导的舒张活性 (FMD)和硝酸甘油介导的舒张活性 (NTGMD)的变化 ,并以 18例健康者作为对照 ;同时采用酶联免疫检测法 (ELISA)测定卡维地洛治疗前后高血压患者血浆氧化低密度脂蛋白(ox LDL)的变化。结果 :健康对照组的FMD显著高于高血压患者美托洛尔或卡维地洛治疗前的FMD ,而 3组间NTGMD的差异无显著统计学意义。卡维地洛组治疗后FMD显著性升高 ,NTGMD无显著性改变。卡维地洛组治疗后血浆ox LDL显著降低。结论 :卡维地洛可能通过其抗氧化活性改善高血压患者的血管内皮依赖性舒张功能。

AIM: To investigate the effects of carvedilol on vascular endothelial function in patients with essential hypertension. METHODS: Flow-mediated endothelium-dependent dilation (FMD) and nitroglycerin-mediated endothelium-independent dilation (NTGMD) were assessed by high-resolution ultrasound technique in the brachial artery of 16 or 19 patients with essential hypertension treatment using metoprolol or carvedilol for 12 weeks, respectively; 18 healthy cases were taken as controls. The plasma concentrations of ox-LDL were measured before and after taking carvedilol for the patients. RESULTS: FMD values in healthy controls were higher than those of hypertensive patients before taking metoprolol or carvedilol (P< 0.01). No significant differences were found in NTGMD among 3 groups. After treatment with carvedilol for 12 weeks, the FMD values were improved significantly from ( 4.7± 1.3)% to ( 7.4± 1.5)% (P< 0.01), and plasma concentration of ox-LDL was decreased significantly from 0.64± 0.16 μg·L -1 to 0.52± 0.15 μg·L -1 (P< 0.05). No significant differences were found in NTGMD of the patients treated with metoprolol or carvedilol. CONCLUSION: Carvedilol can improve endothelium-dependent vasodilation in patients with essential hypertension through a mechanism probably related to an antioxidant effect.