通过脉搏波分析比较咪达普利对中心和外周动脉压的影响

Effects of Imidapril on Peripheral Blood Pressure and Central Blood Pressure Through Pulse Wave Analysis

目的 :比较咪达普利对中心动脉压和外周动脉压的影响。方法 :经 2周的安慰剂洗脱后 ,年龄 18～ 79岁的 5 3例轻、中度原发性高血压患者每日服用咪达普利 5～ 10mg共治疗 6周。所有患者在开始服药前及研究结束时均做脉搏波检查。只有完成 6周治疗的患者列入最终分析。结果 :共有 48例患者完成该研究。经 6周治疗后 ,脉搏波所有观察指标显著下降 (P均 <0 0 5～ 0 0 0 1) ,且中心动脉收缩压和脉压下降幅度显著大于肱动脉收缩压和脉压下降 (P值分别为 0 0 0 2和 0 0 0 3 )。结论 :咪达普利降低外周动脉压和中心动脉压均有效 ,且降低收缩压和脉压在中心动脉比外周动脉显著 ,其差异可能系波反射降低所致。

Objective:The purpose of this study was to evaluate the effects of the angiotensin-converting enzyme (ACE)inhibitor imidapril on the peripheral blood pressure and the central blood pressure in Chinese patients with essential hypertension. Methods:After 2 weeks of placebo run-in period,53 patients with mild or moderate essential hypertension received imidapril (5 to 10 mg per day)for 6 weeks of treatment. Before the active treatment was given and at the end of the study,pulse wave recordings were performed in all the patients. Only those who completed 6 weeks of active treatment were included in the final analysis. Results:Forty-eight patients (male 38)completed the study. After six weeks of treatment,there was a significant reduction in all observed parameters of pulse wave (all p values<0.01).The reduced values of central systolic pressure and pulse pressure were significantly greater than those of peripheral systolic pressure and pulse pressure (p =0.002 and 0.003,respectively). Conclusions:Imidapril is effective for the reduction of both peripheral blood pressure and central blood pressure in the treatment of hypertension. Moreover,imidapril has a greater reduction in central systolic pressure and pulse pressure than that in peripheral systolic pressure and pulse pressure. The difference may be due to the reduction of wave reflection by imidapril.