Effects of Angiotensin II Type 1 Receptor Blocker on Blood Pressure Variability and Cardiovascular Remodeling in Hypertensive Patients on Chronic Peritoneal Dialysis
Effects of Angiotensin II Type 1 Receptor Blocker on Blood Pressure Variability and Cardiovascular Remodeling in Hypertensive Patients on Chronic Peritoneal Dialysis
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DOI：
10.1159/000210572
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发表时间：
2009-01-01
影响因子：
--
通讯作者：
Umemura, Satoshi
中科院分区：
文献类型：
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作者：
Shigenaga, Atsu-ichiro;Tamura, Kouichi;Umemura, Satoshi
目的：在这项研究中，我们研究了在常规降压治疗基础上加用血管紧张素II 1型受体阻滞剂（ARB）坎地沙坦或缬沙坦是否能改善腹膜透析高血压患者的血压（BP）变异性。研究方法：将45例接受慢性腹膜透析治疗的高血压患者随机分配至坎地沙坦（n = 15）或缬沙坦（n = 15）ARB治疗组或对照组（n = 15）。在基线和治疗后6个月，进行24小时动态血压监测、超声心动图和臂踝脉搏波速度（baPWV）测量。结果：治疗6个月后，对照组和ARB组的24小时动态血压值下降相似。然而，根据24小时动态血压的标准差评估的短期血压变异性在ARB组中显著降低，但在对照组中保持不变。此外，通过利钠肽、超声心动图和baPWV评估的心血管重构参数在ARB组中显著改善，但在对照组中没有改善。结论：ARB治疗和对照降压治疗对腹膜透析高血压患者24小时动态血压值的控制相似。然而，ARB治疗有利于抑制病理性心血管重构，降低血压变异性。版权所有（C）2009 S. Karger AG，巴塞尔
Aims: In this study, we examined whether addition of an angiotensin II type 1 receptor blocker (ARB), candesartan or valsartan, to conventional antihypertensive treatment could improve blood pressure (BP) variability in hypertensive patients on peritoneal dialysis. Methods: 45 hypertensive patients on chronic peritoneal dialysis therapy were randomly assigned to the ARB treatment groups either by candesartan (n = 15) or valsartan (n = 15), or the control group (n = 15). At baseline and 6 months after the treatment, 24-hour ambulatory BP monitoring, echocardiography, and measurement of brachial-ankle pulse wave velocity (baPWV) were performed. Results: After the 6 months of treatment, 24-hour ambulatory BP values were similarly decreased in both the control group and ARB groups. However, short-term BP variability assessed on the basis of the standard deviation of 24-hour ambulatory BP was significantly decreased in the ARB groups, but remained unchanged in the control group. Furthermore, parameters of cardiovascular remodeling assessed by natriuretic peptides, echocardiography, and baPWV were significantly improved in the ARB groups but not in the control group. Conclusion: ARB treatment and control antihypertensive treatment similarly controlled 24-hour ambulatory BP values in hypertensive patients on peritoneal dialysis. However, ARB treatment is beneficial for the suppression of pathological cardiovascular remodeling with a decrease in BP variability. Copyright (C) 2009 S. Karger AG, Basel