【正文】 + + + + + + AIx (%) + + + + + + “ Atenolol” vs “amlodipine” CAFE study. Circulation 2020。 ? Peking Union Medical College, Beijing 100037, China. ? b. Medical Professorial Unit, St. Vincent’s Hospital, New South Wales University, NSW ? 2020, Australia. Change from baseline to the end of treatment in Imdapamide(n=51) and Enalapril (n=50)group 8090100110120130140150160t i m AORTA8090100110120130140150160t im epressure (mmHg)b a s e l i n e e n d o f s t u d yRADIALss8090100110120130140150160t i m eAORTA8090100110120130140150160t im epressure (mmHg)b a s e l i n e e n d o f s t u d yNO DIFFERENTIAL EFFECT OF FELODIPINE ON CENTRAL AORTIC . BRACHIAL SYSTOLIC PRESSURE IN TONOMETER SUBSTUDY OF FEVER TRIAL XJ Jiang?, MF O’Rourke?, LS Liu?, YQ Zhang?, XY He?, QC Cheng?, H Lou? ? Division of Hypertension, Fuwai Hospital amp。 SUPERIOR EFFECT OF AN ANGIOTENSIN CONVERTING ENZYME INHIBITOR OVER A DIURETIC FOR REDUCING AORTIC SYSTOLIC PRESSURE J Hypertens. 2020 May。 177。 脈壓變化 (mmHg) 反射波增壓變化 (mmHg) 177。 舒張壓變化 (mmHg) 177。 咪達(dá)普利治療 6周后肱動脈血壓變化與中心動脈血壓變化的比較 肱動脈 中心動脈 P 收縮壓變化 (mmHg) 177。 中心動脈 脈搏波通過已驗證的轉(zhuǎn)換函數(shù)從橈動脈脈搏波實(shí)時生成 。s Clinic, University of New South Wales, Sydney, Australia ? Heart 2020。ARB ? Diuretics ? Spironolactone ? Agents acting on collagen crosslinking ? Vasopeptidase inhibitors The effect of nitroglycerin on wave reflection. From O’Rourke et al Quantification of glyceryl trinitrate effect through analysis of the synthesised ascending aortic pressure waveform ? X J Jiang1, M F O39。 THERAPY Therapy for Arterial Stiffness Any antihypertensive drug that reduces mean arterial pressure results in passive decrease in arterial stiffness 從病理生理上已經(jīng)注意到動脈僵硬是心血管事件重要的中心環(huán)節(jié)，那么動脈僵硬度的降低是否比血壓降低更重要，能獨(dú)立預(yù)測心血管危險的降低？ The goal of treatment for a selective increase in PP amp。x10 4 ) 21 19 17 15 13 11 9 7 Pulse wave velocity (m/s) Nonobese Obese r = p BMI amp。 Arnold Hodder 2020 PWV with age Reproduced from Avalio,et al. Change in contour and amplitude of pressure waves recorded in the radial artery and carotid in normal subjects between the first and eighth decade of life Disorders with great effects on arterial stiffness ? Hypertension ? Arteriosclerosisgeneralized degeneration of medial elements in elastic arteries ? Atherosclerosis ? Diabetes mellitus ? Premature aortic degeneration ? Obesity ? All these disorders result in artery stiffening. However, to some extent, the increased arterial stiffness are reversible by treatment. Pressure/diameter relationships show schematically for an elastic artery of a normal subject(left) and an agematched patient with hypertension(right) ARTERIAL STIFFNESS amp。 92: 595–600. Arterial pulse and pulse wave velocity(PWV) PWV=Distance/Pulse transit time Augmentation Index(AI)=Δp/pp AI is a time domain estimater of the contribution of the reflections relative to the pulse pressure Applanation tonometry Pressure Recordin