| Vascular endothelial cells ( VEC ) are the monolayer tabular cells that adhere to the surface of blood vessel. Vascular endothelium is not only a simple protective screen between the blood flow and vascular wall, but also a group of cells system with the function of complex metabolism and endocrine. Endothelial dysfunction include endothelium-dependent vasodilatation(EDVD) and endothelium-independent vasodilatation ( EIVD ). Since the anatomic location of VEC is in a fragile function interface, its function is easy to disorder, and is related to the occurrence and development of the various diseases such as arteriosclerosis hypertension and heart failure. Drug treatment to the endothelial dysfunction has become the tendency of cardiovascular disease field, it is a channel of treatment and prevention the related disease.Hypertension is now the one of the international diseases with very high incidence. At present, it is considered that in the occurrence and development of hypertension, the unbalance between endothelin(ET) and nitrogen oxide (NO) which are excreted by VEC plays an importance role. Adjusting the vascular endothelial cellular damaging factors and the excretive medium by the measures such as drugs, and consequently reversing the endothelial function, has become the newtherapeutic direction of cardiovascular disease. Now there are 6 kinds of drugs for hypertension treatment. Recently, ACEI and ARB are the antihypertensive drugs with most rapid research. Therefore, the study of the antihypertensive effect and improvement on endothelial function of the two kinds of drugs will help clinicians to select antihypertensive drugs suitablly and treat patient better. Objective1. To compare the effects of ACEI and ARB on hypertension and its clinical significance.2. To investagate the changes of nitrogen oxide (NO) and endothelin (ET) levels in normotensive subjects and patients with hypertension and its clinical significance.3. To survey the feasibility repeatability and veracity of studying endothelial function with noninvasive ultrasound method. To compare it to the results of laboratory.4. To survey the effects of ACEI and ARB on the levels of NO and ET.5. To compare the improvement by ACEI and ARB on endothelial function with noninvasive ultrasound method and its clinical significance.6. To survey the possible occurrence and development mechanism of Endothelial dysfunction, to offer strong theoretical basis for more effective treatment hypertension and prevention the occurrence of hypertension complications.Methods The study population included 68 patients (40 men and 28 women, 52. 49 ±8. 46 years, range 35-65) with 1-2 degree essential hypertension and 24 matched healthy subjects. The patients were accord with the hypertension standard of WHO/ISH, ie. seated SBP≥140 mmHg, < 180 mmHg; And (or) seated DBP≥90 mmHg, <110mmHg. They were randomized to ACEI treatment group ( n = 34 ) and ARB treatment group ( n = 34 ). Thepatients were treated with ACEI or ARB for 8 weeks. The plasma NO -. ET levels FMD and NTG-MD were observed before and after the treatment and compared with one another. Results1. ACEI had the same reducing effect in hypertension as ARB ( P >0. 05).2. The ET levels of hypertension patients is higher than that of matched healthy subjects ( P <0.001), and NO levels is apparently lower than that of compare group {P <0. 001).3. After treatment with ACEI or ARB, the ET levels of hypertension patients apparently reduced, while the NO levels obviously rised. There was no statistical significance between two groups (P >0. 05).4. FMD of hypertension patients was notablely lower than that of compare group before treatment (P <0. 001).5. FMD was significently increased after treated with ARB [ ( 10. 02 ±1.81)%VS(7. 65 + 1.84 )%, P <0.00l].6. FMD was significently increased after treated with ACEI [ ( 9. 93 ±1.57)%VS(7. 84+1.50)%, P <0. 001].7. FMD was no statistical significance between two groups after treated with ACEI or ARB(P >0. 05).Conclusion1. Endothelial dysfunction existed in 1~...
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