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【medical-news】缬沙坦可改善2型糖尿病患者动脉弹
Dr. Janaka Karalliedde of King's College London School of Medicine, UK, and colleagues conducted a 24-week randomized trial to determine whether the angiotensin receptor blocker valsartan would improve arterial stiffness, as estimated from aortic pulse wave velocity, to a greater extent than the calcium channel blocker amlodipine in diabetic patients with systolic hypertension and albuminuria, both of which are independent predictors of cardiovascular disease.
After a 4-week washout phase in which patients were treated with moxonidine (which has minimal impact on vessel wall properties), 131 patients with pulse pressure of at least 60 mm Hg and raised albumin excretion rate received either valsartan 160 mg or amlodipine 5 mg. After 4 weeks, hydrochlorothiazide 25 mg/d was added to valsartan, and the dose of amlodipine was titrated up to 10 mg to ensure equivalent blood pressure control.
At 24 weeks, brachial and central aortic pulse pressure had fallen to a similar extent in both groups. However, a significantly greater reduction (mean -0.9 m/s) in aortic pulse wave velocity was observed in the valsartan group compared to the amlodipine group (p = 0.002). Furthermore, the valsartan group had a significant decrease in albumin excretion rate, from 30.8 to 18.2 mcg/min (p < 0.001), whereas the amlodipine group had a nonsignificant increase, from 27.5 to 32.6 mcg/min.
"As reversibility of arterial stiffness in response to antihypertensive lowering therapy is an important modifiable risk factor for survival in patients with end-stage renal failure, our results emphasize the need for early therapies, which beyond blood pressure lowering, provide a beneficial supplementary reduction in aortic pulse wave velocity," Dr. Karalliedde and colleagues conclude.
Hypertension 2008;51:1617-1623. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。
NEW YORK (Reuters Health) Jun 06 - Valsartan improves arterial stiffness to a greater extent than amlodipine in patients with type 2 diabetes with systolic hypertension and albuminuria, according to findings published in the June issue of Hypertension.
纽约（路透社 健康）6月6日－根据高血压杂志7月份刊出的一篇文章报道，对合并收缩期高血压和蛋白尿的2型糖尿病患者，缬沙坦较氨氯地平在更大程度上改善动脉僵硬度。
Dr. Janaka Karalliedde of King's College London School of Medicine, UK, and colleagues conducted a 24-week randomized trial to determine whether the angiotensin receptor blocker valsartan would improve arterial stiffness, as estimated from aortic pulse wave velocity, to a greater extent than the calcium channel blocker amlodipine in diabetic patients with systolic hypertension and albuminuria, both of which are independent predictors of cardiovascular disease.在伴用收缩期高血压和蛋白尿的糖尿病患者，血管紧缩素受体阻断剂是否可以在更大程度上改善动脉僵硬度，较钙通道阻滞剂氨氯地平？就此，来自英国伦敦大学国王学院医学部的Janaka Karalliedde医生及同事通过评估大动脉脉搏波速度的方法进行了一项为期24周的随机试验。
After a 4-week washout phase in which patients were treated with moxonidine (which has minimal impact on vessel wall properties), 131 patients with pulse pressure of at least 60 mm Hg and raised albumin excretion rate received either valsartan 160 mg or amlodipine 5 mg. After 4 weeks, hydrochlorothiazide 25 mg/d was added to valsartan, and the dose of amlodipine was titrated up to 10 mg to ensure equivalent blood pressure control.
经莫索尼定（它可最大限度的降低对血管壁性质的影响）洗脱4周后，131名脉压≥60 mm Hg、白蛋白排泄率增加的患者将接受目标药物治疗：缬沙坦160mg或氨氯地平5mg。4周后，缬沙坦组加用氢氯噻嗪25 mg/d,为了保证同等的血压水平氨氯地平组药物剂量逐渐增加到10mg。
At 24 weeks, brachial and central aortic pulse pressure had fallen to a similar extent in both groups. However, a significantly greater reduction (mean -0.9 m/s) in aortic pulse wave velocity was observed in the valsartan group compared to the amlodipine group (p = 0.002). Furthermore, the valsartan group had a significant decrease in albumin excretion rate, from 30.8 to 18.2 mcg/min (p < 0.001), whereas the amlodipine group had a nonsignificant increase, from 27.5 to 32.6 mcg/min.
到了第24周，肱动脉和中心动脉脉压两组降低到差不多的程度。然而，和氨氯地平组比较，缬沙坦组大动脉脉搏波速度非常明显的降低（平均－0.9 m/s，p = 0.002）。此外，缬沙坦组白蛋白排泄率也显著地下降――从30.8 mcg/min降到18.2 mcg/min (p < 0.001), 而氨氯地平组白蛋白排泄率变化无显著意义――从27.5 mcg/min到18.2 mcg/min。
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作者:admin@医学,生命科学 2010-09-25 05:11
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