Large artery stiffness in hypertension
Large artery stiffness in hypertension
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DOI：
10.1097/00004872-199715022-00009
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发表时间：
1997-03-01
影响因子：
4.9
通讯作者：
Lacolley, P
中科院分区：
文献类型：
--
作者：
Benetos, A;Laurent, S;Lacolley, P
高血压对大动脉的影响大动脉的机械特性通过缓冲每搏输出量和传播压力脉冲对心血管血液动力学做出重要贡献。血压持续升高通常会导致大动脉僵硬，特别是当存在其他风险因素时。反过来，增加的僵硬度通过增加收缩压而加重高血压，并可诱发心脏肥大和动脉病变。流行病学研究强烈表明，动脉硬化的受试者具有高脉压，并且大动脉硬化与独立于其他心血管风险因素的过度发病率和死亡率相关。环境和遗传因素除了高血压和衰老之外，影响动脉壁细胞外基质组成的各种环境和遗传因素可增加动脉硬度，临床研究表明某些基因型的存在可能是动脉硬度的特别重要的风险标志，并且可调节高血压、衰老和脂质对大动脉的影响。非侵入性方法现在已经使得检测大动脉的改变成为可能。在抗高血压药物中，血管紧张素转换酶抑制剂和钙通道阻滞剂已被证明在改善大动脉顺应性方面非常有效，并且对可改变动脉结构和功能的代谢因素（如脂质、血糖和胰岛素耐受性）无不良影响，因此这些药物可能特别适用于治疗动脉僵硬度增加的患者。基因型的确定可能有助于将来选择抗高血压治疗。
Effects of hypertension on large arteries The mechanical properties of large arteries make a major contribution to cardiovascular haemodynamics through the buffering of stroke volume and by propagation of the pressure pulse. A sustained increase in blood pressure often leads to stiffness of the large arteries, especially when other risk factors are present. The increased stiffness, in turn,aggravates hypertension by increasing systolic blood pressure and can induce cardiac hypertrophy and arterial lesions, Epidemiological studies strongly suggest that subjects with stiffer arteries have a high pulse pressure, and that stiffening of large arteries is associated with excess morbidity and mortality independently of other cardiovascular risk factors.Environmental and genetic factors Apart from high blood pressure and ageing, various environmental and genetic factors that influence the composition of the extracellular matrix of the arterial wall can increase arterial stiffness, Clinical studies suggest that the presence of some genotypes may be a particularly important risk marker for arterial stiffness, and may modulate the effects of hypertension, ageing and lipids on large arteries.Effects of antihypertensive drugs The development of accurate, non-invasive methods has now made it possible to detect alterations of the large arteries. Among antihypertensive drugs, angiotensin converting enzyme inhibitors and calcium channel blockers have proved to be highly effective in improving large artery compliance, and have shown no adverse effects on metabolic factors that can alter arterial structure and function such as lipids, plasma glucose and insulin tolerance, Therefore these drugs may be particularly suitable for treating patients with increased arterial stiffness, Finally, a determination of genotypes may be helpful in the future in choosing antihypertensive therapy.