Resumo

TOBILLI, J. E. et al. Pulse wave velocity and urinary albumin excretion in hypertensive patients treated with perindopril. Medicina (B. Aires) [online]. 2002, vol.62, n.6, pp.544-550. ISSN 0025-7680.

Systolic and diastolic blood pressures and urinary albumin excretion (UAE) have been recognized as predictors for cardiovascular risk. Furthermore, arterial compliance (AC) disorders assessed by increased aortic pulse wave velocity (PWV) are closely related to changes in blood pressure and strongly correlated with cardiovascular mortality and presence or extent of atherosclerosis. Our purpose in the present study was to determine a relationship between AC using PWV and UAE in a group of non-smoking patients with essential hypertension, and the level of interaction of ACE inhibition on these two variables. A total of 70 non-smoking never treated hypertensive patients (33 men and 37 women), aged 50 ± 7 years (range 35-69), have been enrolled in this study. All of them underwent PWV by a computerized device (Complior) and UAE determination by radial immunodiffusion method, on baseline and after six months of treatment with perindopril (4.6 ± 1.4 mg/day). We have found a significant decrease of systolic blood pressure (160.2 ± 10.6 vs. 131.9 ± 7.1 mmHg, p<0.01), diastolic blood pressure (100.6 ± 5 vs. 81.6 ± 4.8 mmHg, p< 0.01), PWV (13.4 ± 1 vs. 9.1 ± 0.9 m/sec, p< 0.01), and UAE (42.2 ± 19.3 vs. 11.1 ± 3.6 mg/day, p< 0.01) at the end of the sixth month when they were compared to baseline values. Furthermore, renal function was also improved by the treatment at the end of the study as illustrated by creatinine clearance (87.5 + 22.5 vs. 102.1 + 23.5 ml/min, p<0.01). Moreover, a high positive correlation between UAE and PWV at the beginning of the study (r= 0.81; p<0.01) and after six months of treatment (r= 0.66; p< 0.01) was observed. In addition, PWV vs. UAE, differences between sixth month and baseline have shown a high correlation (r= 0.67; p< 0.01) and using a multiple regression test we found that PWV (t ratio 5.76; p< 0.001) was the most important and significant independent variable that correlates with UAE. These results suggest the existence of a real link between UAE and AC in non-smoking patients with arterial hypertension, and that ACE inhibition can similarly modify these two parameters.

Palavras-chave : Arterial compliance; Pulse wave velocity; Urinary albumin excretion; ACE inhibitors.

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