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Intensive blood pressure control on arterial stiffness among older patients with hypertension

Chinese Medical Journal 2024年第9期137卷 1078-1087页

作者： Shuyuan Zhang Yixuan Zhong Shouling Wu Hailei Wu Jun Cai Weili Zhang On behalf of the STEP Study Group National Clinical Research Center of Cardiovascular Diseases Fuwai HospitalNational Center for Cardiovascular DiseasesPeking Union Medical College&Chinese Academy of Medical SciencesBeijing 100037China Department of Cardiology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China State Key Laboratory of Cardiovascular Disease Fuwai HospitalNational Center for Cardiovascular DiseasesPeking Union Medical College&Chinese Academy of Medical SciencesBeijing 100037China Department of Cardiology Kailuan General HospitalTangshanHebei 063000China Central China Subcenter of National Center for Cardiovascular Diseases Henan Cardiovascular Disease CenterFuwai Central-China Cardiovascular HospitalCentral China Fuwai Hospital of Zhengzhou UniversityZhengzhouHenan 450046China 不详

Background:arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease(CVD),but the relationship between blood pressure lowering and arterial stiffening is still uncertain,especially in older *** study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with ***:The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients(STEP)trial was a multicenter,randomized,controlled trial performed at 42 clinical centers throughout China,and 8511 patients aged 60-80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure(SBP)target of 110 mmHg toarterial stiffness was evaluated at the 3-year follow-up.A total of 5339 patients who had twice repeated measurements were included in this *** in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression *** Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD ***:The changes in baPWV were 61.5 cm/s(95%confidence interval[CI]:49.8-73.2 cm/s)in the intensive treatment group and 98.4 cm/s(95%CI:86.7-110.1 cm/s)in the standard treatment group(Parterial stiffness,with an annual change of 23.1 cm·s^(-1)·year-1 vs.36.7 cm·s^(-1)·year^(-1)of baPWV in the intensive and standard treatment groups,*** a median follow-up period of 3.36 years,primary CVD outcomes occurred in 77(2.9%)patients in the intensive treatment group compared with 93(3.5%)in the standard treatment *** tre

关键词： Hypertension arterial stiffness Cardiovascular disease Older people Blood pressure Pulse wave velocity

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Reference values of carotid intima-media thickness and arterial stiffness in Chinese adults based on ultrasound radio frequency signal: A nationwide, multicenter study

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中华医学杂志(英文版) 2024年第15期137卷 2024 Jul 3页

作者： Xing Changyang Xie Xiujing Wu Yu Xu Lei Guan Xiangping Li Fan Zhan Xiaojun Yang Hengli Li Jinsong Zhou Qi Mu Yuming Zhou Qing Ding Yunchuan Wang Yingli Wang Xiangzhu Zheng Yu Sun Xiaofeng Li Hua Zhang Chaoxue Zhao Cheng Qiu Shaodong Yan Guozhen Yang Hong Mao Yinjuan Zhan Weiwei Ma Chunyan Gu Ying Chen Wu Xie Mingxing Jiang Tianan Yuan Lijun Department of Ultrasound The Second Affiliated Hospital of Xi’an Jiaotong University China Xi’an Shaanxi China Department of Echocardiography First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang China Department of Ultrasound Renmin Hospital of Wuhan University Wuhan Hubei China Department of Ultrasound Yan’an Hospital The Affiliated Hospital of Kunming Medical University Kunming Yunnan China Department of Ultrasound Yan’an University Xianyang Hospital Xianyang Shaanxi China Department of Function Examination Beijing University of Chinese Medicine Third Affiliated Hospital Beijing China Department of Ultrasound Xi’an Central Hospital Xi’an Shaanxi China Cadre’s Wards Ultrasound Department Diagnostic Ultrasound Center First Hospital of Jilin University Changchun Jilin China Department of Echocardiography Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University Urumqi Xinjiang China Department of Ultrasound First Affiliated Hospital of Anhui Medical University Hefei Anhui China Department of Ultrasound Medicine Tangdu Hospital Air Force Medical University Xi’an Shaanxi China Department of Abdominal Ultrasound The Affiliated Hospital of Qingdao University Qingdao Shandong China Department of Ultrasound Second Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong China Department of Ultrasound The First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology Baotou Inner Mongolia China Department of Medical Ultrasonics First Affiliated Hospital of Guangxi Medical University Nanning Guangxi China Department of Ultrasound The Fourth People’s Hospital Xi’an Shaanxi China Department of Ultrasound Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China Department of Cardiovascular Ultrasound The First Hospital of China Medical University Shenyang Liaoning China Department of Ultrasound Center Affiliated Hospital of G

Background: Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical ***: A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of ***: All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (allP for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants o

关键词： Intima-media thickness arterial stiffness Reference values Ultrasound radio frequency signal Wave reflections

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Pilot study on the effect of flavonoids on arterial stiffness and oxidative stress in chronic kidney disease

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World Journal of Nephrology 2024年第3期13卷 41-48页

作者： Anastasia Vagopoulou Panagiotis Theofilis Despina Karasavvidou Nasra Haddad Dimitris Makridis Stergios Tzimikas Rigas Kalaitzidis Nephrology Department“C.Katsinas” General Hospital of Ptolemaida“Mpodosakeio”Ptolemaida 50200Greece Center for Nephrology“G.Papadakis” General Hospital of Nikaia-Piraeus“Agios Panteleimon”Nikaia-Piraeus 18454Greece

BACKGROUND Flavonoids,the main class of polyphenols,exhibit antioxidant and antihypertensive *** To prospectively investigate the impact of flavonoids on arterial stiffness in patients with chronic kidney disease(CKD)stagesⅠ-Ⅳ.METHODS In this prospective,single-arm study,CKD patients with arterial hypertension and diabetes mellitus were *** demographic,clinical,and laboratory variables were *** received daily treatment with a phenol-rich dietary supplement for 3 *** pressure,arterial stiffness(carotidfemoral pulse wave velocity,central pulse pressure),and oxidative stress markers(protein carbonyls,total phenolic compound,total antioxidant capacity)were measured at baseline and at study *** Sixteen patients(mean age:62.5 years,87.5%male)completed the *** intervention,peripheral systolic blood pressure decreased significantly by 14 mmHg(Parterial stiffness,and oxidative stress markers.

关键词： Flavonoids Chronic kidney disease arterial stiffness Oxidative stress Carotid-femoral pulse wave velocity

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arterial stiffness as a Cardiovascular Risk Factor in Prostate Cancer Survivors:A Case-Control Study

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Journal of Science in Sport and Exercise 2021年第2期3卷 171-178页

作者： Lynnette M.Jones Rebekah Wilson Lee Stoner J.Chris Baldi School of Physical Education Sportand Exercise SciencesUniversity of OtagoPO Box 56DunedinNew Zealand Department of Sport and Exercise Science University of North CarolinaChapel HillNC 27599-8700USA Department of Medicine University of OtagoPO Box 56DunedinNew Zealand

Purpose In New Zealand,prostate cancer (PCa) is the most commonly diagnosed cancer in men and the third most common cause of male cancer *** these patients,the most common non-cancer related cause of death is cardiovascular disease (CVD).Aortic arterial stiffness may be clinically viable solution for detecting and tracking CVD risk factor in PCa *** aim of the study was to determine whether aortic arterial stiffness is increased in PCa survivors compared to age-matched *** Participants recruited for this prospective comparative study were PCa survivors who had completed treatment(other than endocrine therapy) or were on active surveillance compared,or were age-matched non-cancer *** a single 1-h appointment,all participants had measures of aortic arterial stiffness,arterial wave reflection,central blood pressure and body composition *** Ninety-eight men were recruited,51 PCa survivors and 47 *** was no significant between group dif-ference for aortic arterial stiffness[12.0 m/s (SD:1.7) vs.12.0 m/s (SD:1.9),P=0.953,d=0.0].Fat free mass[60.7 kg(SD:4.9) vs.65.1 kg (SD:8.3),P=0.007,d=0.6]and skeletal muscle index[8.6 kg/m2 (SD:0.6) vs.9.0 kg/m2 (SD:0.9),P=0.050,d=0.5]were lower in the PCa *** Aortic arterial stiffness is not increased (worse) in men with PCa who receive various treatments,compared to age-matched *** findings may indicate that factors other than increased aortic arterial stiffness contribute to heightened risk of cardiovascular events in this population.

关键词： Prostate cancer Cardiovascular disease Risk arterial stiffness

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Relationships between use of statins and arterial stiffness in normotensive and hypertensive patients with coronary artery disease

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Chinese Medical Journal 2013年第16期126卷 3087-3092页

作者： WANG Zhi-guang CHEN Bing-wei L(U) Na-qiang CHENG Yan-mei DANG Ai-min State Key Laboratory of Cardiovascular Disease Department ofCardiology Fuwai Hospital National Center for CardiovascularDiseases Chinese Academy of Medical Sciences and Peking UnionMedical College Beijing 100037 China

Background Statins improve arterial stiffness in patients with coronary artery disease （CAD）.Hypertension is a predominant contributor of arterial ***,the influence of hypertension on the effect of statins for improving arterial stiffness in CAD patients has seldom been ***,in this study,we investigated the relationships between statin use and arterial stiffness in normotensive and hypertensive CAD *** Brachial-ankle pulse wave velocity （ba-PWV） was measured in 437 patients,including 220 hypertensive CAD patients （121 used statins,99 did not） and 217 normotensive CAD patients （105 used statins,112 did not）.The normotensive and hypertensive CAD patients were matched according to age,sex,and body mass index （BMI）.Results In the normotensive and hypertensive CAD patients,lipid profiles were significantly improved in the statin group compared with the non-statin *** significant differences in the administered statins （i.e.,atorvastatin,simvastatin,rosuvastatin,and pravastatin） and statin therapy duration were found between normotensive and hypertensive CAD patients （all P＞0.05）.No significant correlation of ba-PWV and statin therapy duration was found in all CAD patients,normotensive CAD patients,or hypertensive CAD patients （all P＞0.05）.ba-PWV in the statin group was significantly lower than that in the non-statin group in normotensive CAD patients （（1331.68±167.52） cm/s vs.（1468.61±244.54） cm/s,P=0.002） but not in hypertensive CAD patients （P＞0.05）.In multiple linear regression analyses,statin therapy was significantly associated with ba-PWV after adjusting for confounding variables in normotensive CAD patients （P=0.018） but not in hypertensive CAD patients （P＞0.05）.Conclusions Statins may significantly improve arterial stiffness in CAD patients,and hypertension may probably influence the effectiveness of statin therapy in improving arterial stiffness in this *** studies are required to investigate the

关键词： arterial stiffness statins hypertension coronary artery disease

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Increased arterial stiffness in Subjects with Pre-diabetes among Middle Aged Population in Beijing,China

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Biomedical and Environmental Sciences 2013年第9期26卷 717-725页

作者： SHEN Li ZHANG Yan Ge LIU Min WU Liu Xin QIANG Dong Chang SUN Xue Lei LIU Lin JIANG Yuan Yuan Department of Epidemiology and Biostatistics School of Public Health Peking University Health Science Center Institute of Aviation Medicine AF

Objective To investigate the relationship between arterial stiffness and pre-diabetes when assessed by the new glycosylated hemoglobin Ale （HbAlc） 5.7%-6.4% criterion or by impaired fasting glucose in middle aged Chinese. Methods 1122 adults aged 55 years or younger in the health examination centers for physical check-ups were enrolled in the two large-sized Tertiary Comprehensive Hospitals in Beijing from June 2011 to June 2012 after excluding those who previously had been diagnosed or treated as diabetes or cardiovascular disease. Subjects with a diagnosis of pre-diabetes according to impaired fasting glucose （IFG）（fasting plasma glucose （FPG） levels at 5.6-6.9 mmol/L）, HbA^c levels at 5.7%-6.4%, or both, were classified into four groups for observation：（1） Normoglycaemia （HbA^c〈5.7% and FPG 〈5.6 mmol/L）; （2） IFG alone （FPG levels at 5.6-6.9 mmol/L and HbA1c〈5.7% ）; （3） HbAI~ 5.7%-6.4% alone （HbA^c levels at 5.7%-6.4% and FPG 〈5.6 mmol/L）; and （4） both HbA1c 5.7%-6.4% and IFG （l-lbA1~ levels at 5.7%-6.4% and FPG levels at 5.6-6.9 mmol/L）. All subjects were measured for weight, height, waist circumference, blood pressure, fasting plasma glucose, HbA1c, lipid profile and brachial-ankle pulse wave velocity （baPWV）. Results The mean values of baPWV were 1282±8, 1311±10, 1398±30, and 1418_±27 cm/s （Mean_±SE） in Normoglycaemia, HbA~ 5.7%-6.4% alone, IFG alone and the both HbAlc 5.7%-6.4% and IFG groups, respectively. After adjusting for age, gender, blood pressure, BMI and triglyceride, baPWV was significantly higher in subjects with both HbAlc5.7%-6.4% and iFG compared among the subjects with Normoglycaemia （1350±14 vs. 1301±6 cm/s, P=0.002） and HbA1c 5.7%-6.4% alone （1350±14 vs. 1309±8 cm/s, P=0.013）.Conclusion Subjects with pre-diabetes exhibited a greater arterial stiffness.

关键词： Pre-diabetes Vascular stiffness arterial stiffness

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Association between serum homocysteine and arterial stiffness in elderly： a community-based study

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Journal of Geriatric Cardiology 2014年第1期11卷 32-38页

作者： Song ZHANG Yong-Yi BAI Lei-Ming LUO Wen-Kai XIAO Hong-Mei WU Ping YE Department of Geriatric Cardiology Chinese PLA General Hospital No.28 Fuxing Road Beijing 100853 China School of Medicine Nankai University N0.94 Weijin Road Tianjin 300071 China

Background arterial stiffness and homocysteine are both powerful predictors of cardiovascular disease, especially in older popula tions. Previous studies have investigated the association of homocysteine with arterial stiffness in human subjects, while the relationship between homocysteine and arterial stiffness in the elderly is still indefinite. The current study examined the association of homocysteine with arterial stiffness in Chinese community-based elderly persons. Methods We related serum levels of homocysteine to two measures of arte- rial stiffness （carotid-femoral pulse wave velocity （PWV） and carotid-radial PWV） in 780 participants （46.3% men, mean age 71.9 years （ranging 65-96 years old）） from two communities of Beijing, China. arterial stiffness were measured within two days of the time of bio- marker measurement. Results In multiple-adjusted models, homocysteine levels was strongly associated with the carotid-femoral PWV （standardized 13 = 0.13, P 〈 0.001）, even after adjustment for classical risk factors of cardiovascular disease. The association is also stronger when the carotid-femoral PWV is elevated above normal, whereas no significant association with homocysteine was observed for ca-rotid-radial PWV. Conclusions In Chinese elderly persons, serum homocysteine levels are associated with alterations of aortic stiffness.

关键词： The elderly Homocysteine arterial stiffness Pulse wave velocity

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Association between non-alcoholic fatty liver disease and arterial stiffness in the non-obese, non-hypertensive, and non-diabetic young and middle-aged Chinese population

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2014年第10期15卷 879-887页

作者： Xin-yan YU Yi ZHAO Xiao-xiao SONG Zhen-ya SONG International Health Care Center the Second Affiliated Hospital School of Medicine Zhejiang University Department of Endocrinology the Second Affiliated Hospital School of Medicine Zhejiang University

Background and objective： Non-alcoholic fatty liver disease（NAFLD） is associated with arterial stiffness in the general population. Age, obesity, hypertension, and diabetics are risk factors for arterial stiffness. In this study, we aimed to investigate the association between NAFLD and arterial stiffness as measured by brachial-ankle pulse wave velocity（baPWV） in the non-obese, non-hypertensive, and non-diabetic young and middle-aged Chinese population. Methods： A cross-sectional study with 1296 non-obese, non-hypertensive, and non-diabetic young and middle-aged（20–65 years） subjects undergoing routine medical check-ups in the International Health Care Center of the Second Affiliated Hospital of School of Medicine of Zhejiang University was carried out. Fatty liver was diagnosed by ultrasonography, and baPWV was measured using an automatic waveform analyzer. The subjects were classified into two groups according to the presence of NAFLD, and divided into a further two groups according to their baPWV. Results： The overall incidence of NAFLD was 19.0%, and NAFLD patients had a significantly higher level of baPWV than the controls（（1321±158） cm/s vs.（1244±154） cm/s; P〈0.001）. The incidence of NAFLD was clearly higher in the increased baPWV group than in the normal baPWV group（29.3% vs. 16.9%; P〈0.001）, and the incidence increased in line with the increase of baPWV quartiles in the normal range as well as with the severity of arterial stiffness（both P for trend 〈0.001）. Multiple linear logistic regression analysis showed that the presence of NAFLD was positively and independently associated with baPWV. Conclusions： Our results suggest that the presence of NAFLD is associated with arterial stiffness as measured by baPWV in the non-obese, non-hypertensive, and non-diabetic young and middle-aged Chinese population.

关键词： Non-alcoholic fatty liver disease arterial stiffness Brachial-ankle pulse wave velocity Risk factor

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Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function

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Journal of Geriatric Cardiology 2012年第2期9卷 158-165页

作者： Su-Yan Bian Hong-Yang Guo Ping Ye Lei-Ming Luo Hong-Mei Wu Wen-Kai Xiao Li-PingQi He-Peng Yu Liu-Fa Duan The Second Department of Geriatric Cardiology Chinese PLA General Hospital 28 Fuxing Road Beijing 100853 China Departmen of Cardiology Chinese PLA General Hospital 28 Fuxing Road Beijing 100853 China

Objective Both decreased glomemlar filtration rate （GFR） and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. Methods In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR 〉 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity （PWVcf） and carotid-radial PWV （PWVcr） using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes （AIx-75） was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. Results The mean estimated GFR （eGFR） of the study group was 100.05 ＋ 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVef and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AJx-75. Conclusions In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.

关键词： arterial stiffness Augmentation index Pulse wave velocity Glomerular filtration rate Chinese women

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Effect of aliskiren on arterial stiffness, compared with ramipril in patients with mild to moderate essential hypertension

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Chinese Medical Journal 2013年第7期126卷 1242-1246页

作者： GUO Jian-qiang WANG Hong-yi SUN Ning-ling Department of Cardiology Peking University People's Hospital Beijing 100044 China

Background Aliskiren is a novel blood pressure-lowering agent acting as an oral direct renin inhibitor. The aim of this study was to assess the effect of aliskiren on arterial stiffness, compared with that of ramipril in mild to moderate essential hypertensive patients. Methods Following a two week placebo run-in period, patients with a mean sitting diastolic blood pressure （ms-DBP）〉95 and 〈110 mmHg （1 mmHg=0.133 kPa）, and a mean sitting systolic blood pressure （ms-SBP）〈180 mmHg were randomly allocated to treatment with aliskiren （150 mg/d, n=20） or ramipril （5 mg/d, n=20） for eight weeks. Blood pressure, plasma renin activity, and the brachial-ankle pulse wave velocity （ba-PWV） were measured before and after eight weeks of treatment. Results Eight weeks of treatment significantly decreased systolic blood pressure and diastolic blood pressure in both the aliskiren group and ramipril group. The hypotensJve effect did not differ between the two groups. Plasma renin activity decreased after aliskiren treatment and increased after ramipril treatment. There was no significant difference in baseline ba-PWV between the aliskiren and ramipril groups （P=-0.892）. The ba-PWV was significantly reduced in both the aliskiren group （1535 （1405-1666） vs. 1464 （1360-1506） cm/s）（P 〈0.01） and the ramipril group （1544 （1433-1673） vs. 1447 （1327-1549） cm/s）（P 〈0.01）. No statistically significant difference was found in the decline of ba-PWV between the two groups （P=0.766）. Conclusions The current study revealed that aliskiren （150 mg/d） could ameliorate arterial stiffness and its effect was similar to ramipril （5 mg/d） in mild to moderate hypertensive patients, indicating that in addition to lowering blood pressure, aliskiren had beneficial effect on vascular protection.

关键词： aliskiren arterial stiffness hypertension ramipril

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