Objective To evaluate the differences in the effects of angiotensin converting enzyme inhibitor ( ACEI) and angiotensin II receptor blocker ( ARB ) on arterial stiffness in hypertensive patients. Methods We searched databases for the randomized controlled trials ( RCTs ) which compared the effects of ACEI and ARB on arterial stiffness in hypertensive patients up to January 2012, and analyzed the data by Cochrane Collaboration's RevMan 5. 0 software. Results A total of 6 elegi-ble RCTs were included for meta analysis, which demonstrated that there was a significant difference between the effects of ACEI and ARB on vascular stiffness. ACEI was significantly superior to ARB in improving vascular stiffness [ AbaPWV = - 113. 53, 95%CI ( -152.21, - 74. 84)]; However, these two drugs showed no significant difference in lowering either systolic blood pressure [ ASBP = 2. 09, 95% CI ( - 2. 50, 6. 67 ), P = 0. 37 ] or diastolic blood pressure [ ADBP = 1. 75, 95% CI ( -1.55, 5.04), P =0. 30]. Conclusion ACEI is superior to ARB in improving vascular stiffness in hypertensive patients.%目的 系统评价血管紧张素转换酶抑制剂(ACEI)和血管紧张素Ⅱ受体拮抗剂(ARB) 对高血压患者动脉僵硬度作用的差异.方法 计算机检索Cochrane图书馆临床对照试验资料库(CCRCT)、PubMed、EMBase、万方数据库、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBMdisc)、维普数据库(VIP).检索时间为各数据库建库至2012年1月.纳入采用ACEI或ARB治疗原发性高血压患者的随机对照试验(RCT),采用RevMan5.0软件进行统计分析.比较ACEI和ARB对高血压患者脉搏波传导速度、收缩压、舒张压等指标的影响.结果 共检索到相关文献833篇,初筛后收集到符合标准的文献51篇,进一步筛选纳入6项RCT,共计231例患者.Meta分析结果表明,ACEI在改善动脉僵硬度方面优于ARB,差异有统计学意义[肱-踝脉搏波速度差(ΔbaPWV)＝-113.53,95%CI(-152.21,-74.84)].但收缩压和舒张压降低程度间差异均无统计学意义[收缩压差(ΔSBP)＝2.09,95%CI(-2.50,6.67),P=0.37;舒张压差(ΔDBP)＝1.75,95%CI(-1.55,5.04),P=0.30].结论 ACEI在改善高血压患者动脉僵硬度方面优于ARB.
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