Effects of isosorbide mononitrate and AII inhibition on pulse wave reflection in hypertension
Effects of isosorbide mononitrate and AII inhibition on pulse wave reflection in hypertension
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DOI：
10.1161/01.hyp.0000049622.07021.4f
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发表时间：
2003-02-01
期刊：
影响因子：
8.3
通讯作者：
Gilfillan, KL
中科院分区：
文献类型：
--
作者：
Stokes, GS;Barin, ES;Gilfillan, KL
孤立性收缩期高血压的主动脉脉波轮廓常出现一个突出的反射峰，与心脏射血产生的入射波相结合，使脉压变宽。我们研究了缓释硝酸盐制剂和2种血管紧张素11 （All）抑制剂（All受体拮抗剂和ACE抑制剂）对脉搏波反射过度引起的高增强指数高血压患者主动脉脉波轮廓和全身血压的影响。两项双盲、随机、安慰剂对照交叉研究共纳入16例对常规降压治疗有抵抗性的老年收缩期高血压患者。在第一项研究中，测定了单剂量安慰剂、单硝酸异山梨酯、依普沙坦和卡托普利的药效学反应；在另一组中，单剂量单硝酸异山梨酯和安慰剂在基线时对所有抑制剂治疗的受试者进行比较。用血压计测量血压，用压扁式血压计测量桡动脉脉波分量。所有3种药物均可降低肱动脉收缩压、主动脉收缩压和主动脉脉压。对主动脉脉波轮廓的定性影响不同：卡托普利和依泊沙坦均未显著改变增强指数，但降低了增强指数(P
The aortic pulse wave contour in isolated systolic hypertension often shows a prominent reflection peak, which combines with the incident wave arising from cardiac ejection so as to widen pulse pressure. We investigated the effects of an extended-release nitrate preparation and of 2 angiotensin 11 (All) inhibitors (an All receptor antagonist and an ACE inhibitor) on the aortic pulse wave contour and systemic blood pressure in hypertensive subjects with high augmentation index caused by exaggerated pulse wave reflection. Two double-blind, randomized, placebo-controlled crossover studies were carried out in a total of 16 elderly patients with systolic hypertension resistant to conventional antihypertensive therapy. In I study, pharmacodynamic responses to single doses of placebo, isosorbide mononitrate, eprosartan, and captopril were determined; in the other, single-dose isosorbide mononitrate and placebo were compared in subjects treated with All inhibitors at baseline. Blood pressure was measured by sphygmomanometry and pulse wave components by applanation tonometry at the radial artery. All 3 agents were shown to decrease brachial systolic blood pressure, aortic systolic blood pressure, and aortic pulse pressure. Qualitative effects on the aortic pulse wave contour differed: augmentation index was not significantly altered by either captopril or eprosartan but was decreased (P