The effects of angiotensin receptor blockers vs. calcium channel blockers on the acute exercise-induced inflammatory and thrombotic response
The effects of angiotensin receptor blockers vs. calcium channel blockers on the acute exercise-induced inflammatory and thrombotic response
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DOI：
10.1038/hr.2012.134
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发表时间：
2012-12-01
影响因子：
5.4
通讯作者：
Stefanadis, Christodoulos I.
中科院分区：
文献类型：
--
作者：
Liakos, Charalampos I.;Vyssoulis, Gregory P.;Stefanadis, Christodoulos I.
动脉高血压是急性冠状动脉综合征的一个既定危险因素，体力活动可能引发此类事件的发生。所涉及的机制包括小的、发炎的冠状动脉斑块的破裂和血栓形成因子的激活。血压（BP）降低治疗与亚临床炎症和血栓形成在休息和运动期间的有益效果。本前瞻性研究旨在比较不同的抗高血压药物对运动过程中炎症和血栓反应的影响。共60例从未接受过治疗的高血压患者被随机分配至基于血管紧张素受体阻滞剂（ARB）或非二氢吡啶类钙通道阻滞剂（CCB）的治疗方案。炎症或冠状动脉疾病患者被排除在外。在药物血压正常化后6个月，患者接受了最大跑步机运动试验。在患者休息和运动高峰时采集血样，测定高敏C反应蛋白（hsCRP）、血清淀粉样蛋白A（SAA）、白色血细胞（WBC）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、总纤维蛋白原（TF）和血管性血友病因子（vWF）水平以及纤溶酶原激活物抑制剂-1（派-1）活性。除派-1随运动时间延长而降低外，其余指标均随运动时间延长而升高（P
Arterial hypertension is an established risk factor for acute coronary syndromes, and physical exertion may trigger the onset of such an event. The mechanisms involved include the rupture of a small, inflamed, coronary plaque and the activation of thrombogenic factors. Blood pressure (BP)-lowering treatment has been associated with beneficial effects on subclinical inflammation and thrombosis at rest and during exercise. This prospective study sought to compare the effect of different antihypertensive drugs on the inflammatory and thrombotic response during exercise. A total of 60 never-treated hypertensive patients were randomized to an angiotensin receptor blocker (ARB)- or non-dihydropyridine calcium channel blocker (CCB)-based regimen. Patients with inflammatory or coronary artery disease were excluded. Six months after pharmaceutical BP normalization, the patients underwent a maximal treadmill exercise testing. High-sensitivity C-reactive protein (hsCRP), serum amyloid A (SAA), white blood cells (WBC), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), total fibrinogen (TF) and von Willebrand factor (vWF) levels, as well as plasminogen activator inhibitor-1 (PAI-1) activity were measured in blood samples taken while the patients were at rest and during peak exercise. All of these biomarkers increased with exercise, except PAI-1, which decreased (P