培哚普利及美托洛尔对中心动脉压的作用

目的比较培哚普利和美托洛尔对轻中度高血压病患者中心动脉压与肱动脉压的影响。方法在冠状动脉造影结束后,分别同步测量145例高血压病或(和)冠心病患者升主动脉根部(直接测量法)和肱动脉(袖带加压法)的血压,其中单药降压治疗二周以上的轻中度高血压病患者分为培哚普利组(4mg/d,62例)、美托洛尔组(25mg/d,39例)。结果升主动脉收缩压高于袖带加压法测量的肱动脉收缩压9.6mmHg(P<0.01),升主动脉舒张压低于袖带加压法肱动脉舒张压2.0mmHg(P<0.01),升主动脉脉压较肱动脉脉压大11.6mmHg(P<0.01)。虽然培哚普利组和美托洛尔组袖带加压法测得的肱动脉压相同,但是培哚普利组的升主动脉收缩压低于美托洛尔组(P<0.05)。结论升主动脉压与袖带加压法测得的肱动脉压差异有非常显著意义。虽然培哚普利和美托洛尔降低肱动脉压效果相似,但培哚普利降低升主动脉收缩压较美托洛尔更显著。

Efficacy of Perindopril Compared with Metoprolol on Central Blood Pressure

Objective To investigate the effects of the angiotensin-converting enzyme inhibitor(ACEI) perindopril and beta blockers metoprolol on the brachial blood pressure and the central blood pressure in patients with essential hypertension Methods One hundred and fourty five cases were studied in catheterization laboratory. Ascending aortic pressure was measured with physiology recorder during coronary angiography, and brachial blood pressure (BP) with a standard sphygmomanometer meantime. One hundred and one cases with mild or moderate essential hypertension received perindopril (4 mg/d, n=62), or metoprolol(25 mg/d, n=39) for > 2 weeks before the study. Results The ascending aortic SBP was 9.62 mm Hg higher than the brachial SBP (P<0.01); DBP was 1.96 mm Hg lower (P<0.01) in hypertensive patients. No significant difference (all P>0.05) in baseline BP between the perindopril and metoprolol groups was found. After treatment for 2 weeks, the brachial blood pressure were similiar in the two groups (P>0.05). However the ascending aortic SBP in perindopril group is markedly lower than that in metoprolol group (P<0.05). Conclusion Although both perindopril and metoprolol are similarly effective in reducing brachial arterial blood pressure, perindopril decreases central systolic pressure more significantly than metoprolol.