篇名 | Effects of Anti-Hypertensive Monotherapy with Either Calcium Channel Blocker or Angiotensin Receptor Blocker on Arterial Stiffness, Central Hemodynamics, and Ventriculo-Arterial Coupling in Uncomplicated Hypertension Patients |
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卷期 | 29:1 |
作者 | Heng-Hsu Lin 、 Chia-Sung Wang 、 Jiunn-Lee Lin 、 Juey-Jen Hwang 、 Lian-Yu Lin |
頁次 | 019-027 |
關鍵字 | Arterial stiffness 、 Central arterial pressure 、 Hypertension 、 Pulse wave velocity 、 Ventriculo-arterial coupling 、 MEDLINE 、 SCI 、 Scopus |
出刊日期 | 201301 |
Objectives: This study is designed to investigate the effects of anti-hypertensive monotherapy [either calcium channel blocker (CCB) or angiotensin receptor blocker (ARB)] on pulsatile hemodynamic parameters in patients with uncomplicated hypertension.
Methods: This is a longitudinal observational study. For simplicity, we included patients with uncomplicated hypertension who receivedmono anti-hypertensive therapy with ARB or CCB. Hemodynamic parameters including central arterial pressure (CAP), aortic characteristic impedance (Zc), augmentation index (AI), brachial-ankle pulse wave velocity (baPWV), heart-ankle pulse wave velocity (haPWV), cardiac ultrasonographic parameters and ventriculo-arterial (VA) coupling were measured before, 1 month and 3 months after treatment.
Results: A total of 74 subjects were included in our study for analysis from 2007-2008. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and central systolic arterial pressure (CSAP) were significantly reduced 1 and 3 months after initiation of therapy. Among the pulsatile hemodynamic parameters, only the baPWV was significantly reduced (from1537.78 200.63 cm/s to 1460.06 186.09 cm/s to 1456.53 196.03 cm/s, p for trend = 0.016). The haPWV only decreased with borderline significance (from 1015.38 124.26 cm/s to 978.88 126.55 cm/s to 967.99 103.37 cm/s, p for trend = 0.041). The other pulsatile hemodynamic parameters remained unchanged before and after therapy. Subgroup analysis (age above or below52 years) showed that the baPWVwas significantly reduced only in the younger group.
Conclusions: Among the pulsatile hemodynamic parameters, only the baPWV was effectively reduced by either CCB or ARB. The improvement of PWV was more evident in younger subjects.