| Autor: |
Van Bortel, Luc M.A.B., Kool, Mirian J.F., Spek, Janneke J. |
| Zdroj: |
The American Journal of Cardiology; November 1995, Vol. 76 Issue: 15 p46E-49E, 4p |
| Abstrakt: |
Distensibility and compliance are large artery properties, that may be important in cardiovascular disease. Distensibilityis a determinant of the pulsatile stress on the vessel wall and is thought important in ageing and atherosclerotic disease. Compliancereflects the buffering capacity of the arteries and is a major determinant of the afterload on the heart. In hypertension large arteries are getting stiffer, resulting in a decreased distensibility and compliance. Decrease in blood pressure by itself can improve large artery properties. Despite a decrease in blood pressure, not all antihypertensive drugs improve large artery properties. Compliance is improved by firstline antihypertensive drugs such as angiotensin-converting enzyme (ACE) inhibitors, calcium antagonists, β-blockers with vasodilating properties, selective β1-blockers and some diuretics. Recent data suggest that ACE inhibitors such as perindopril improve distensibility and compliance of large arteries more than diuretics such as amiloride/ hydrochlorothiazide. Apart from the indirect effect (decrease in blood pressure), this makes a direct effect of perindopril on large artery properties very likely. ACE inhibitors such as perindopril decrease the afterload on the heart more than diuretics such as amiloride/hydrochlorothiazide by both a more pronounced decrease in systemic vascular resistance and an increase in large artery compliance. |
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