缬沙坦对盐敏感性高血压患者血压及血管紧张素Ⅱ和醛固酮水平的干预作用

Interference of valsartan on blood pressure and plasma angiotensin Ⅱ,aldosterone in salt sensitive essential hypertensive patients

目的 :探讨选择性血管紧张素Ⅱ受体 (AT1)拮抗剂对盐敏感性高血压患者血压 ,血管紧张素Ⅱ(AngⅡ )和醛固酮 (ALD)水平的干预作用。方法 :对84例原发性高血压患者用静脉盐水负荷法确定盐敏感性 ,并观察应用缬沙坦后血压及血清AngⅡ和ALD水平的变化。结果 :原发性高血压盐敏感组与非盐敏感组在应用缬沙坦治疗 2、4、6、8wk后坐位收缩压分别下降了 17.5± 4 .3、11.0± 1.4mmHg坐位舒张压下降了 17.0± 3.7、7.7± 1.1mmHg ,有显著的统计学意义 (P <0 .0 0 1)。用药后 ,两组患者血浆AngⅡ水平均明显升高 ,ALD水平显著下降。结论 :缬沙坦对原发性高血压患者盐敏感组与非盐敏感组均有较好的降压作用 ,而对盐敏感组的降压作用更显著 ,且对二组患者血浆AngⅡ和ALD水平有一定的干预作用。

AIM: To investigate the interference of valsartan on blood pressure and plasma angiotensin Ⅱ (ang Ⅱ), aldosterone (ALD) in salt sensitive essential hypertensive patients. METHODS: Eighty-four adult hypertensive patients were enrolled in study, and the salt sensitivity was determined by acute intravenous salt water loading according to Sullvan's criteria. The change of blood pressure and plasma ang Ⅱ, and ALD were compared before and after the treatment. RESULTS: At the end of 2, 4, 6, and 8 weeks, patients with salt sensitive essential hypertensive (group ss) and no salt sensitive essential hypertensive (group nss) were measured. The results showed that sitting systolic blood pressure (SiSBP) was decreased by 17.5 ± 4.3 and 11.0 ± 1.4 mmHg, and sitting diastolis blood pressure (SiDSP) was decreased by 17.0 ± 3.7 and 7.3 ± 1.1 mmHg after the treatment. It was found that patients showed significantly higher plasma ang Ⅱ and lower plasma ALD in group ss and group nss. CONCLUSION: Valsartan can significantly control SiSBP and SiDBP for both groups, interfered plasma angiotensin Ⅱ and I aldosterone, and be more effective for patients with salt sensitive essential hypertensive.