[Regional arterial hemodynamics and carotid circulation in essential arterial hypertension. Effect of nitrendipine in patients over 40 years of age].
Lesions of the arterial wall constitute one of the main complications of essential hypertension. The final objective of all antihypertensive drugs is to reduce the cardiovascular morbidity and mortality rates, but their short and medium term objectives must be to normalise blood pressure values and to correct the functional and structural abnormalities consecutive to arterial hypertension. In this double-blind drug versus placebo study conducted in 20 patients (14 men, 6 women) aged over 40, the effects of nitrendipine on regional arterial haemodynamics (aortic territory, upper limb, lower limb) and carotid circulation were evaluated. Nitrendipine was administered daily in doses of 20 mg during 1 month. After 4 weeks of treatment, the treated group showed a fall in blood pressure and an improvement in the pulse wave propagation (an index of arterial distensibility) in the carotido-femoral territory (11.4 +/- 1.7 vs 9.9 +/- 1.6 m/s; P < 0.01) and in the humero-radial territory (12.9 +/- 2.0 vs 11.6 +/- 2.1 m/s; P < 0.05); there was no change in the femoro-tibial territory (13.2 +/- 1.8 vs 12.5 +/- 1.7 m/s; NS). The haemodynamics of the common carotid artery showed no change in carotid diameter or blood velocity, and small lowering of local resistances (28.1 +/- 9.1 vs 24.6 +/- 4.9 mmHg.s.ml-1; P < 0.05). This study demonstrates that in patients older than 40 years a long-term treatment with nitrendipine lowers blood pressure, does not alter the common carotid flow and improves arterial distensibility. The arterial effects seem to vary according to the arterial territories considered.
Asmar
R
R
Service de Médecine interne I, INSERM U337, Hôpital Broussais, Paris.
Benetos
A
A
Ghodsi
N
N
Meilhac
B
B
Safar
M
M
D000328:Adult; D000367:Age Factors; D001783:Blood Flow Velocity / Q000502:physiology*; D001795:Blood Pressure Determination; D002340:Carotid Artery Diseases / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D004311:Double-Blind Method; D004341:Drug Evaluation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009568:Nitrendipine / Q000627:therapeutic use*; D010919:Placebos
D010919:Placebos; D009568:Nitrendipine
Hémodynamique artérielle régionale et circulation carotidienne dans l'hypertension artérielle essentielle. Application à la nitrendipine chez le sujet âgé de plus de 40 ans.