Vol 12, No 3 (2008)
Original paper
Published online: 2008-05-29
The influence of treatment with quinapril on arterial stiffness, blood viscosity and arterial shear stress among patients with essential hypertension
Nadciśnienie tętnicze 2008;12(3):182-189.
Abstract
Background to analyze the influence of quinapril on aortic
PWV, whole blood viscosity (WBV), shear stress in the
ascending aorta (AA) and in the common carotid artery
(CCA), prometaloproteinase-1 (proMMP-1) and its tissue
inhibitor (TIMP-1) plasma concentration in patients with
essential arterial hypertension (HT).
Material and methods 55 patients, aged 52.8 ± 13.8 yrs. with HT 1 and 2 st. were treated with quinapril 10 mg/d. If BP was above 140/90 mmHg the dose of quinapril was increased up to 40 mg/d. at 3 month visit. At baseline and then after 3 and 6 months of treatment PWV, WBV, proMMP-1 and TIMP-1 were determined. Shear stress in AA and (CCA) was calculated from WBV, internal vessel diameter and blood flow velocity (Vmax) measured ultrasonographically.
Results After 6 months treatment with quinapril significant decrease was observed in BP (155.6/92.0 mm Hg vs. 135.9/82.9 mm Hg, p < 0.001), PWV (10.35 m/s vs. 9.64 ms, p < 0.001), WBV (5.14 cP vs. 4.86 cP, p < 0.05) and TIMP-1 (111.0 ng/ml vs. 94.1 ng/ml, p < 0.001). In the same period increased: Vmax in AA (127.1 cm/s vs. 131.3 cm/s, p < 0.05, Vmax in CCA (69.9 cm/s vs. 78.4 cm/s, p < 0.05), shear stress in CCA (22.2 dyne/cm2 vs. 24.7 dyne/ /cm2, p < 0.05 ). Significant positive correlation was observed between PWV and TIMP-1, and negative correlations between PWV and Vmax in AA, PWV and Vmax in CCA, as well as PWV and shear stress in CCA.
Conclusions Quinapril improves blood rheology and reduces arterial stiffness by inhibition of collagen metabolism. The effect on arterial stiffness seems to be secondary to increase of arterial shear stress.
Material and methods 55 patients, aged 52.8 ± 13.8 yrs. with HT 1 and 2 st. were treated with quinapril 10 mg/d. If BP was above 140/90 mmHg the dose of quinapril was increased up to 40 mg/d. at 3 month visit. At baseline and then after 3 and 6 months of treatment PWV, WBV, proMMP-1 and TIMP-1 were determined. Shear stress in AA and (CCA) was calculated from WBV, internal vessel diameter and blood flow velocity (Vmax) measured ultrasonographically.
Results After 6 months treatment with quinapril significant decrease was observed in BP (155.6/92.0 mm Hg vs. 135.9/82.9 mm Hg, p < 0.001), PWV (10.35 m/s vs. 9.64 ms, p < 0.001), WBV (5.14 cP vs. 4.86 cP, p < 0.05) and TIMP-1 (111.0 ng/ml vs. 94.1 ng/ml, p < 0.001). In the same period increased: Vmax in AA (127.1 cm/s vs. 131.3 cm/s, p < 0.05, Vmax in CCA (69.9 cm/s vs. 78.4 cm/s, p < 0.05), shear stress in CCA (22.2 dyne/cm2 vs. 24.7 dyne/ /cm2, p < 0.05 ). Significant positive correlation was observed between PWV and TIMP-1, and negative correlations between PWV and Vmax in AA, PWV and Vmax in CCA, as well as PWV and shear stress in CCA.
Conclusions Quinapril improves blood rheology and reduces arterial stiffness by inhibition of collagen metabolism. The effect on arterial stiffness seems to be secondary to increase of arterial shear stress.
Keywords: arterial hypertensionquinaprilarterial stiffnessblood viscosityshear stressprometalloproteinase-1metalloproteinase-1 tissue inhibitor