The improvement effect of enhanced external counterpulsation on blood pressure and endothelial dysfunction in elderly hypertensive patients
Yang Haiyan
Gao Yu
Yuan Wenjing
Abstract：Objective Primary hypertension is closely related to endothelial dysfunction.This study aims to evaluate the improvement effect of enhanced extracorporeal counterpulsation(EECP)on blood pressure and endothelial dysfunction in elderly hypertensive patients.Methods From November 2021 to July 2022,360 patients with essential hypertension were randomly divided into 3 groups with 120 patients in each group,taking inpatients and outpatients with essential hypertension in our hospital as research objects:The control group was given lifestyle guidance and medication compliance management,the drug group was given bisoprolol orally on the basis of lifestyle guidance,and the drug+EECP group was given EECP on the basis of gabisoprolol treatment,5 times a week for 1 hour each time,for a total of 3 months.Serum endothelin-1(ET-1)and nitric oxide(NO)levels,carotid artery ultrasonography,clinical blood pressure and 24 h ambulatum blood pressure were compared between the three groups before and after intervention.Any side effects during the intervention were recorded.Results The control group received lifestyle guidance and medication adherence management,while the medication group received oral bisoprolol on the basis of lifestyle guidance.The medication+EECP group received EECP on the basis of lifestyle plus bisoprolol treatment,5 times a week,1 hour/time,for a total of 3 months.Compare the levels of serum endothelin-1(ET-1)and nitric oxide(NO),carotid ultrasound,clinical blood pressure,and 24 h dynamic blood pressure among three groups of patients before and after intervention.Record the side effects during the intervention period.Compared with the control group and the drug group,the endothelial function of the drug+EECP group was significantly improved:serum ET-1 levels,clinical blood pressure,and 24 h dynamic blood pressure decreased compared to before intervention and the other two groups,while NO levels and carotid ultrasound parameters peak systolic velocity(PSV),end diastolic velocity(EDV),and fluid shear stress(FSS)increased(P＜0.05).Correlation analysis showed that there was a correlation between FSS and changes in ET-1(r=-0.121,P=0.022),NO-1(r=0.151,P=0.004),and clinical systolic blood pressure(r=-0.154,P=0.003)(before intervention).Even after adjusting for confounding factors,this correlation still exists(P＜0.001).Conclusion Bisoprolol combined with EECP can improve endothelial function in elderly patients with primary hypertension.
Keywords：Enhanced external counterpulsationEssential hypertensionElderly patientsEndothelial function24h ambulatory blood pressure monitoring
Publication Date：2024-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 720-724 )