Aortic stiffness is reduced beyond blood pressure lowering by short-term and long-term antihypertensive treatment: a meta-analysis of individual data in 294 patients
Aortic stiffness is reduced beyond blood pressure lowering by short-term and long-term antihypertensive treatment: a meta-analysis of individual data in 294 patients
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DOI：
10.1097/hjh.0b013e328346a583
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发表时间：
2011-06-01
影响因子：
4.9
通讯作者：
Boutouyrie, Pierre
中科院分区：
文献类型：
--
作者：
Ong, Kim-Thanh;Delerme, Samuel;Boutouyrie, Pierre
背景动脉僵硬度是高血压患者心血管事件和死亡率的独立预测因子。除了降低血压外，不同类别的抗高血压药物对改善动脉僵硬度的影响还没有广泛获得。我们的目的是确定是否可以改善动脉僵硬度，因为抗高血压治疗独立的血压lowering.Methods我们进行了荟萃分析的个人数据从15个随机，对照，双盲，平行组试验在我们的实验室在1987年和1994年之间。主要终点为294例未经治疗的轻中度原发性高血压患者治疗后颈动脉-股动脉脉搏波传导速度（PWV）的变化。试验治疗为安慰剂（n=88）、血管紧张素转换酶抑制剂（ACEI）（n= 75）、钙拮抗剂（n=75）、β受体阻滞剂（n=30）和利尿剂（n=26）。活性药物治疗组的PWV显著降低，分别为-0.75和-1.3 m/s，而安慰剂组分别为+0.17和-0.44 m/s。积极治疗与PWV的变化独立相关，分别解释了短期和长期试验中5%和4%的方差。在短期试验中，ACEI在改善动脉僵硬度方面比钙拮抗剂和安慰剂更有效。在长期试验中，ACEI，钙拮抗剂，β-受体阻滞剂，利尿剂降低PWV显着相比，安慰剂。结论我们的研究表明，抗高血压治疗改善动脉僵硬度超出其对血压的影响。J Hypertens 29：1034-1042（C）2011 Wolters Kluwer Health|利平科特威廉姆斯&威尔金斯。
Background Arterial stiffness is an independent predictor of cardiovascular events and mortality in hypertensive patients. The influence of different antihypertensive drug classes on improving arterial stiffness beyond blood pressure reduction is not widely available. We aim to determine whether the artery stiffness can be improved because of antihypertensive treatments independently of blood pressure lowering.Methods We conducted a meta-analysis of individual data from 15 randomized, controlled, double-blind, parallel group trials performed in our laboratory between 1987 and 1994. The primary endpoint was the changes of carotid-femoral pulse wave velocity (PWV) after treatment in 294 patients with mild-to-moderate essential hypertension untreated. Treatments tested were placebo (n=88), angiotensin-converting enzyme inhibitors (ACEIs) (n=75), calcium antagonists (n=75), beta-blocker (n=30), and diuretic (n=26).Results In the short-term and long-term trials, PWV decreased significantly by -0.75 and -1.3 m/s in the active treatment group compared with by +0.17 and -0.44 m/s in the placebo group, respectively. Active treatment was independently related to the changes in PWV and explained 5 and 4% of the variance in the short-term and long-term trials, respectively. In the short-term trials, ACEIs were more effective than calcium antagonists and placebo on improving arterial stiffness. In the long-term trials, ACEI, calcium antagonists, beta-blocker, and diuretic reduced significantly PWV compared to placebo.Conclusion Our study shows that antihypertensive treatments improve the arterial stiffness beyond their effect on blood pressure. J Hypertens 29: 1034-1042 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.