埼玉医科大学雑誌 第32巻 第2号 (2005年4月) 37-43頁 ◇論文(図表を含む全文)は，PDFファイルとなっています．
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Blockade of Renin-Angiotensin System with Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blocker Improves Vascular Distensibility in Non-Diabetic Chronic Kidney Diseases
Taku Mimura (Department of Nephrology, Saitama Medical School, Moroyama, Iruma-gun, Saitama 350-0495, Japan)
We examined the effects of angiotensin inhibition on pulse wave velocity (PWV) for the patients with non-diabetic kidney diseases. Patients were divided into 4 groups according to their renal function and medication. Patients were followed for a year, and PWV was annually measured. Age, heart rate and systolic blood pressure correlated to PWV (R2=0.58, p<0.0001). Regardless of medications, patients with normal kidney function showed well blood pressure control (130±1/72±1 to 129±2/73±2 mmHg, n=48) and no deterioration of renal function (Scr: 0.85±0.03 to 0.89±0.04 mg/dl), but only patients under angiotensin inhibition manifested a decrease in PWV (1914±84 to 1744±64 cm/sec, n=40, p<0.01). Although blood pressure was maintained below 130/80 mmHg in renal insufficiency patients, renal dysfunction progressed (2.21±0.11 to 2.75±0.18 mg/dl, p<0.01, n=43). With angiotensin inhibition, PWV decreased in this population (1703±64 to 1567±57 cm/sec, n=38, p<0.01). The present findings indicate that age, heart rate and systolic blood pressure constitute important determinants of PWV, and suggest that angiotensin blockade helps keep arterial distensibility in patients with chronic non-diabetic kidney diseases.