Blood-pressure-reducing Effects of Anti-low-density Lipoprotein Cholesterol and Anti-hyperglycaemic Treatments in Patients with High Vascular Age for Chronological Age Can Blood Vessels Really be Rejuvenated ?

摘要

Background : The brachial-ankle pulse wave velocity (baPWV, also known as the Vascular age') is a useful index of the degree of arteriosclerosis and is used widely in clinical practice. We focused our attention on low-density lipoprotein (LDLj cholesterol, triglycerides, and blood glucose concentrations, which are major causes of arteriosclerosis, and conducted treatments by setting a control target for each, aiming to normalise the vascular age (baPWV). Methods : We treated 76 patients with hypertension patients (40 males and 36 females) and a baPWV that was elevated for their chronological age with drugs to achieve a serum LDL cholesterol concentration of <80 mg/'dL, a triglyceride of <150 mg/dL, and a maximum blood glucose concentration of <120 mg/dL, but without using antihypertensive drugs. We compared the blood pressure in the recumbent position at the initial examination the blood pressure recorded when the vascular age had returned to, or very closely approximated, the chronological age. Results : The vascular age returned to the chronological age in the majority of patients after a mean of 8.8 months. Both the systohc and diastolic pressures decreased significantly (p<0.0001) from 142.1 to 115.6 mmHg and from 85.1 to 69.3 mmllg, respectively.Discussion : Antihypertensive drugs should not be used hastily to treat patients with mild-to-moderate hypertension if the vascular age exceeds their chronological age. Instead, control of blood LDL cholesterol, triglyceride, and blood glucose concentrations should be achieved beforehand, if possible.