动态血压监测氨氯地平合用依那普利治疗中度高血压病分析

目的 利用动态血压监测(ABPM)技术评价苯磺酸氨氯地平合用马来酸依那普利治疗中度原发性高血压(EH)的疗效.方法 52例中度EH者未服或停用其他降压药2w以上,给予氨氯地平5mg qd,依那普利10mg qd顿服6w所有患者治疗前后均进行ABPM.结果 52例经治疗6w后ABPM明显降低,总有效率90.38%.结论 对中度EH氨氯地平合用依那普利能达到24h平稳降压.     

咪达普利治疗老年高血压患者的动态血压观察

目的:观察咪达普利对轻、中度老年高血压患者的治疗效果。方法:口服咪达普利,观察治疗前后诊室血压、24h动态血压(ABPM)变化及血压谷/峰值。结果:治疗后诊室血压总有效率86.49%,其中收缩压下降12.39%,舒张压下降15.12%;24hABPM:白昼、夜间均值比治疗前均显著下降(P<0.01);降低收缩压和舒张压的谷/峰比值分别为60.7%和73.1%。结论:咪达普利对轻、中度老年高血压有持续稳定的降压效果。     

阿利沙坦酯治疗老年轻-中度原发性高血压的有效性和安全性观察

目的评价阿利沙坦酯治疗老年轻-中度原发性高血压(高血压)的有效性和安全性。方法将60例轻-中度高血压老年患者随机分为阿利沙坦酯组和缬沙坦组,治疗前及治疗12周后监测诊室血压(CBP)、心率、心电图、血常规、尿常规、生化指标,治疗前与治疗12周结束后行24 h动态血压监测(ABPM)。结果治疗12周末,两组的诊室血压,24 h、白昼、夜间平均血压,血压负荷值及夜间下降率均显著下降,与治疗前比较,差异有统计学意义(P0.05),心率无显著变化;阿利沙坦酯降低白昼及诊室收缩压(SBP)和降低24 h、白昼、诊室收缩压幅度优于缬沙坦,差异有统计学意义(P0.05)。两组治疗总有效率、舒张压(DBP)平均降压幅度、血压达标率、谷峰比值(T/P)及平滑指数(SI)比较,差异无统计学意义(P0.05)。两组患者不良反应轻微,均能自行缓解,但在引起转氨酶升高方面比较,阿利沙坦酯更安全。结论阿利沙坦酯治疗老年轻-中度高血压疗效是安全、有效的。     

乐卡地平治疗轻中度原发性高血压的疗效观察

目的 评价乐卡地平治疗轻中度原发性高血压的疗效及安全性.方法 将89例轻中度原发性高血压患者随机分为两组.治疗组予乐卡地平10 mg/d,对照组予氨氯地平10 mg/d.两组均治疗8周,2周洗脱期末和治疗期末所有患者都进行24 h ABPM检查,评估药物安全性和有效性.结果 治疗组与对照组有效率分别为72.0%和77.1%;24 hABPM结果显示服乐卡地平和氨氯地平的患者24 h血压均明显降低,且保持正常的日夜节律,两组的降压达峰时间约6 h,降低日间血压和夜间血压的疗效相当;副反应发生率约5.3%,主要表现为头痛、踝部水肿、头晕、心悸等,程度较轻.结论 乐卡地平明显降低收缩压和舒张压持续24 h,降压疗效与氨氯地平相当.     

甲磺酸氨氯地平治疗非杓型高血压临床观察

目的观察甲磺酸氨氯地平对非杓型高血压病患者血压昼夜节律的影响。方法选择62例经24h动态血压监测血压状态属非杓型的轻至中度原发性高血压患者,采取清晨服用甲磺酸氨氯地平,没次1片,每日1次,观察用药前后24h动态血压参数。结果甲磺酸氨氯地平片治疗12周后,24h平均血压下降显著,对日间及夜间平均SBP与DBP均能等幅度的降低,总有效率为91.8%。结论甲磺酸氨氯地平不仅能24h平稳降低血压,而且能显著改变血压昼夜节律,从而达到保护靶器官的目的。     

苯磺酸左旋氨氯地平降压疗效与药物经济学评价

目的探讨苯磺酸左旋氨氯地平与苯磺酸氨氯地平治疗轻中度原发性高血压的临床疗效。方法选择经2 w洗脱期后诊室血压达到轻中度原发性高血压诊断标准的患者123例,随机分成试验组(口服苯磺酸左旋氨氯地平片,n=62)和对照组(口服苯磺酸氨氯地平片,n=61)。用药前和用药8 w后分别进行24 h动态血压监测(ABMP),观察两组血压控制情况,计算用药前后24 h收缩压、舒张压平滑指数,并比较两种药物的成本效果差异。结果试验组和对照组经8 w治疗后,总有效率分别为87.10%和85.25%,组间差异无统计学意义(P>0.05);两组间不良反应发生率相似(P>0.05);两组收缩压、舒张压的平滑指数均>1,组间差异无统计学意义(P>0.05);试验组、对照组成本效果比分别为202.87和365.28。结论苯磺酸左旋氨氯地平和苯磺酸氨氯地平具有相同的安全性和有效性,但苯磺酸左旋氨氯地平具有成本效果优势。     

动态血压监测评价卡维地洛和美托洛尔的降压效应

目的结合动态血压监测(ABPM)方法评价卡维地洛与美托洛尔对轻、中度高血压的降压效应。方法高血压患者78例随机分为卡维地洛组(n=39)和美托洛尔组(n=39)。分别给予卡维地洛(25~50mg/d,1次/d)和美托洛尔(100~200mg/d,2次/d),治疗12周。观察服药前及服药后12周末的24h、白昼、夜间及各时点的动态血压变化及谷/峰比。结果卡维地洛组和美托洛尔组服药前、服药治疗后12周末的24h、白昼、夜间的平均收缩压、舒张压明显下降,有显著性差异(P<0.05或<0.01)。卡维地洛组服药后12周末各时点收缩压、舒张压较服药前明显下降,有显著性差异(P<0.05)。美托洛尔组服药后12周末各时点收缩压、舒张压较服药前下降,但服药后的第23~24h夜间血压下降不明显(P>0.05)。两组治疗后平均收缩压(SBP)和平均舒张压(DBP)的谷/峰比(T/P值)分别是63%/57%,和59%/51%。结论卡维地洛可维持24h平稳降压;美托洛尔仅能维持22h内血压下降;两者均有满意的谷/峰比。     

诊室外血压控制疗效分析

现在就接受治疗的高血压患者经用动态血压监测(ABPM)所评测的诊室外血压控制疗效进行大样本调查分析。受试对象为12867例接受治疗的高血压患者,均适应接受ABPM监控,年龄皆≥18岁,平均年龄61.9岁,男性52.4%。其高血压均属原发性高血压,并皆已接受了降压药治疗。人均皆随访至少2个月。随访期间均接受了24h ABPM监控,并观察分析服用降压药后,所有高血压患者的诊室内血压理想控制率,以及经ABPM监测所显示的诊室外白昼血压理想控制率等降压疗效间差异,及其相关影响因素。结果显示,经降压药治疗后,所有对象的诊室血压均值为149.4/86.8mm Hg…     

盐酸艾司洛尔并氨氯地平治疗高血压并主动脉夹层的疗效

目的:探讨盐酸艾司洛尔联合苯磺酸氨氯地平治疗高血压合并主动脉夹层对患者血压及心率的影响。方法:高血压合并主动脉夹层患者110例,被随机分为氨氯地平组和联合用药组(氨氯地平+艾司洛尔),各55例。结果:与治疗前相比,治疗0.5、1.5、7h后两组患者收缩压和舒张压均明显下降(P<0.01),治疗7h后,联合用药组患者收缩压显著低于氨氯地平组[(101.5±7.8)mmHg比(123.4±10.2)mmHg,P<0.01]。治疗0.5、1.5、7h后,联合用药组患者心率、脉率乘积(RPP)均显著低于氨氯地平组(P均<0.01)。治疗后,与氨氯地平组比较,联合用药组患者的血压达标率(56.36%比87.27%)、心率达标率(38.18%比92.73%)、心率血压同时达标率(25.45%比81.82%)显著提高(P均<0.01)。结论:盐酸艾司洛尔联合苯磺酸氨氯地平片治疗高血压合并主动脉夹层患者,能够快速、安全、有效地控制血压和心率。     

动态血压监测苯磺酸左旋氨氯地平治疗轻、中度高血压疗效观察

目的 应用动态血压监测评估苯磺酸左旋氨氯地平对轻、中度高血压降压效果.方法 选择42例轻、中度原发性高血压患者,观察苯磺酸左旋氨氯地平治疗前后的诊所偶测血压、动态血压、白昼和夜间的血压负荷及降压谷峰比率.结果 苯磺酸左旋氨氯地平治疗后偶测血压、动态血压均明显降低(P<0.05或P<0.01),降压疗效总有效率为90.5%.结论 对轻度高血压患者苯磺酸左旋氨氯地平能达到24 h全程平稳降血压,是符合时间诊疗学原理的理想降压药物.     

氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床观察

目的探讨氨氯地平阿托伐他汀钙片应用于高血压合并冠心病的临床疗效。方法以我院2011年7月-2014年3月我院就诊确诊的86例高血压合并冠心病患者为研究对象,按随机数字法随机分为观察组与治疗组,其中治疗组43例,对照组43例;治疗组给予氨氯地平阿托伐他汀片治疗,而对照组采用硝苯地平片治疗,比较两组患者临床治疗效果。结果两组患者进行治疗后,两组患者血压下降,心绞痛症状改善,症状改善总有效率观察组显著高于对照组(P0.05);在观察组LDL-C、TC两项治疗后与治疗前比较显著下降,有统计学差异(P0.05),两组患者均无严重不良事件发生。结论氨氯地平阿托伐他汀片治疗高血压合并冠心病患者具有良好的降压效果,改善冠心病症状,有效降低血脂,临床疗效确切,并且方便依从性高。     

A dose-response study of amlodipine in mild to moderate hypertension

The antihypertensive efficacy and suitability for once daily dosing of amlodipine, a new calcium antagonist, was studied in a series of 205 patients with mild to moderate hypertension. The study was conducted double-blind in 13 centres. The starting doses of amlodipine were 1.25, 2.5 and 5 mg, respectively, which were doubled after 4 weeks if normotension or a preset target blood pressure was not reached. Target blood pressure was reached in 25% of patients with placebo, 41% with 2.5 mg of amlodipine, 56% with 5 mg of amlodipine and 73% with 10 mg of amlodipine once daily. The drug was well tolerated at all dose levels and no changes occurred in heart rate, body weight or electrocardiogram during treatment. Amlodipine is a useful new calcium antagonist for the treatment of hypertension producing smooth, dose-dependent blood pressure reductions with convenient once daily dosing.     

Use of 24-h ambulatory blood pressure monitoring to assess blood pressure control: a comparison of olmesartan medoxomil and amlodipine besylate

OBJECTIVE: Olmesartan medoxomil is an angiotensin II receptor blocker with similar antihypertensive efficacy as the calcium channel blocker amlodipine besylate in patients with mild-to-moderate hypertension. In addition to a drug's ability to lower blood pressure, the effectiveness of the agent in enabling patients to achieve specific blood pressure targets is an important clinical consideration. This secondary analysis of a randomized, double-blind study compared the efficacy of olmesartan medoxomil with that of amlodipine besylate in achieving ambulatory blood pressure goals among patients with mild-to-moderate hypertension. METHODS: Following a 4-week placebo run-in, 440 study participants aged >or=18 years were randomized to olmesartan medoxomil (20 mg/day), amlodipine besylate (5 mg/day), or placebo for 8 weeks. The proportion of participants achieving specific systolic and diastolic ambulatory blood pressure goal levels was calculated by dividing the number of participants who had achieved a particular blood pressure goal by the total number of patients in the intent-to-treat population. RESULTS: After 8 weeks of treatment, a mean 24-h ambulatory blood pressure of <130/80 or <130/85 mmHg was achieved by significantly more participants in the olmesartan medoxomil group (18.1 and 30.4%, respectively) than in the amlodipine besylate (7.0 and 14.0%, respectively) or placebo (1.9% for both) groups. The target daytime ambulatory blood pressure of <135/85 mmHg was achieved by more participants in the olmesartan medoxomil group than in the amlodipine besylate group (15.8 vs. 5.8%, respectively; P<0.01). CONCLUSION: In a previous publication of the same study, we demonstrated that starting doses of olmesartan medoxomil and amlodipine besylate produced similar mean reductions in blood pressure. In this subanalysis of the blood pressure data from that primary publication, however, olmesartan medoxomil therapy was shown to result in a greater proportion of patients achieving specific ambulatory blood pressure goals than therapy with amlodipine besylate. As blood pressure goal attainment may be of more direct clinical relevance than numerical blood pressure lowering, the achievement of blood pressure goals should be a key efficacy parameter assessed in clinical trials of antihypertensive medications.     

氨氯地平联合替米沙坦及复方盐酸阿米洛利治疗高血压和左室肥厚的效果及其与瘦素的关系

目的 比较氨氯地平联合应用替米沙坦（氨+替组）及氨氯地平联合应用复方盐酸阿米洛利（氨+阿组）对高血压患者血压及左室肥厚（LVH）的影响,并探讨血压和左室肥厚与血清瘦素水平的关系。方法 将确诊的92例LVH患者随机分配到氨+替组（46例）和氨+阿组（46例）。治疗半年后,观察两组患者心脏形态学、心脏功能及血清瘦素水平的变化。结果 氨+替组及氨+阿组患者经过治疗后,收缩压、舒张压、室间隔厚度、左室质量、左室质量指数及血清瘦素水平与治疗前比较,均有显著降低（均P<0.01）,E/A比值及EF值与治疗前比较有显著增高（P<0.05）,但两组间治疗后收缩压、舒张压差别无统计学意义,余均有显著改变（P<0.05）,氨+替组作用更明显。结论 氨+替组有更好的降压、保护心脏的效果。瘦素参与了左心室肥厚的发生、发展,可作为观察高血压患者病情变化的指标。     

苯磺酸氨氯地平联合雷米普利治疗老年原发性高血压临床观察

目的探讨苯磺酸氨氯地平联合雷米普利治疗老年原发性高血压的临床效果。方法将97例老年原发性高血压患者随机分为联合用药组(A组)50例和单一用药组(B组)47例,B组患者给予单用苯磺酸氨氯地平治疗,A组患者采用苯磺酸氨氯地平联合雷米普利治疗。观察对比两组患者治疗前后收缩压(SBP)及舒张压(DBP)的变化情况,临床疗效及不良反应。结果 A组患者治疗总有效率(82.0%)显著高于B组患者(63.8%),两组比较差异有统计学意义(P0.05),A组患者的临床疗效优于B组患者(P0.05)。治疗后A组患者SBP及DBP均明显低于B组患者,两组比较差异有统计学意义(P0.05或P0.01)。结论苯磺酸氨氯地平联合雷米普利治疗老年原发性高血压患者疗效显著,不良反应轻微,值得推广应用。     

Crossover study of amlodipine versus nifedipine CR with home blood pressure monitoring via cellular phone: internet-mediated open-label crossover trial of calcium channel blockers for hypertension (i-TECHO trial)

OBJECTIVE: We developed a new data collection system named i-converter that could transmit data to a website via cellular phone. Using the system, we compared the effects of two calcium channel blockers on the home blood pressure. METHODS: Amlodipine and nifedipine CR were administered to 41 patients with essential hypertension for more than 6 weeks each in a randomized open-label crossover study. The dose of each drug was increased until the home blood pressure reached the target level of under 135/85 mmHg. RESULTS: The morning home systolic and diastolic blood pressures were significantly lower during nifedipine CR treatment: 133 +/- 10/81 +/- 8 mmHg with amlodipine versus 131 +/- 8/80 +/- 8 mmHg with nifedipine CR, P < 0.05. The morning pulse rate was significantly higher during nifedipine CR treatment (69 +/- 9 beats/min with amlodipine versus 70 +/- 9 beats/min with nifedipine CR, P < 0.05). The evening home blood pressure and pulse rate, however, showed no significant differences between the two drugs (128 +/- 11/74 +/- 7 mmHg and 74 +/- 10 beats/min with amlodipine versus 128 +/- 10/75 +/- 7 mmHg and 74 +/- 9 beats/min with nifedipine CR, all not significant). CONCLUSIONS: Nifedipine CR had a stronger antihypertensive effect than amlodipine during the critical morning period, but the morning pulse rate was higher. Our new data transmission system was effective for collecting precise data on the blood pressure and pulse rate via the internet.     

缬沙坦联合苯磺酸氨氯地平对女性高血压患者血压谷峰比值与平滑指数的影响

目的探讨在女性高血压患者中联用缬沙坦与苯磺酸氨氯地平对于控制血压谷峰比值及平滑指数的作用。方法对我院63例女性高血压患者进行随机分组,将单用苯磺酸氨氯地平、单用缬沙坦和联用两者治疗者各纳入A组、B组和C组,分析并评估3组病例的临床治疗情况。结果与治疗前相比,三组患者的24hSBP、24hDBP、dSBP、dDBP、nSBP和nDBP水平均显著下降（均为P〈0.05）。且除24hDBP之外,C组治疗后其余指标均要较A组和B组改善更明显（P〈0.05）。C组治疗后的血压谷峰比值与平滑指数均要较A组和B组高（P〈0.05）。结论为女性高血压患者提供缬沙坦与苯磺酸氨氯地平治疗有确切效果,对于控制患者血压谷峰比值、平滑指数有重要意义。     

苯磺酸氨氯地平联合阿托伐他汀对原发性高血压病患者颈动脉硬化的影响

目的：探讨苯磺酸氨氯地平与阿托伐他汀联合治疗对原发性高血压病患者颈动脉内膜-中层厚度（IMT）的作用。方法：选择79例合并颈动脉硬化的原发性高血压病患者,随机分为对照组（39例）和试验组（40例）。对照组使用苯磺酸氨氯地平5mg,1次／d,2周后,血压未降至140／90mmHg以下者,增加剂量至10mg,试验组同时口服阿托伐他汀20mg,1次／晚,疗程为28周。比较两组治疗前、后的颈动脉IMT、血压、TG、TC、LDL-C、HDL-C、高敏C反应蛋白（hs-CRP）的变化。结果：服药28周后,两组IMT、血压均较治疗前明显降低（P〈0．05）;其中试验组IMT降低更明显（P〈0．05）。试验组TG、TC、LDL-C、hsCRP明显下降,HDL-C明显增高,与治疗前及对照组治疗前、后比较,差异均有统计学意义（P＜0．05）。结论：苯磺酸氨氯地平联合应用阿托伐他汀对颈动脉IMT消退作用更显著,能有效延缓原发性高血压病患者颈动脉硬化进展。     

Once-daily treatment of patients with hypertension: a placebo-controlled study of amlodipine and benazepril vs amlodipine or benazepril alone

OBJECTIVE: To compare the efficacy, tolerability, and safety of once-daily therapy with amlodipine 5 mg/benazepril 10 mg vs amlodipine 5 mg, benazepril 10 mg, and placebo. DESIGN: Randomised, double-blind, placebo-controlled, parallel-group, multicentre trial. SETTING: Twenty-two clinical centres, including private practice groups and academic research clinics.Patients: A total of 530 patients between 21 and 80 years of age with essential hypertension were screened for the study, and 454 were randomised to treatment with amlodipine 5 mg/benazepril 10 mg, amlodipine 5 mg, benazepril 10 mg, or placebo for 8 weeks. RESULTS: Amlodipine 5 mg/benazepril 10 mg produced greater reductions from baseline in sitting diastolic blood pressure than amlodipine 5 mg (P < 0.03), benazepril 10 mg (P < 0.001), and placebo (P < 0.001). The response rate in the amlodipine 5-mg/benazepril 10-mg treatment group (66.4%) was better than that observed in the amlodipine 5-mg (50.0% P < 0.02), benazepril 10-mg (38.3% P < 0.001), and placebo (24.4% P < 0.001) groups. There was no significant difference in heart rate among the four groups. The incidence of oedema in the amlodipine 5-mg/benazepril 10-mg (1.7%) group was somewhat less than that in the amlodipine 5-mg (4.5%) group. CONCLUSIONS: Therapy with amlodipine 5 mg/benazepril 10 mg was well tolerated and was superior to amlodipine 5 mg, benazepril 10 mg, and placebo in reducing sitting diastolic blood pressure in patients with essential hypertension.     

Amlodipine lowers blood pressure without affecting cerebral blood flow as measured by single photon emission computed tomography in elderly hypertensive subjects.

AIM: To evaluate the effect of amlodipine on blood pressure and cerebral blood flow in elderly subjects with mild to moderate hypertension. METHODS: A double-blind, parallel group study of 26 patients. After a 4-week placebo run-in period, amlodipine (5-10 mg) or matching placebo was given once daily for 8 weeks. RESULTS: Amlodipine significantly reduced blood pressure compared with baseline. Diastolic blood pressure was significantly reduced by amlodipine compared with placebo (P< 0.02 to P< 0.01). Ambulatory blood pressure monitoring showed that blood pressure control was sustained over the 24-h dosing interval. Relative regional cerebral blood flow, assessed using single photon emission computed tomography, was not significantly affected by amlodipine. Three placebo patients, but no amlodipine patients, withdrew because of adverse events. CONCLUSION: Amlodipine was a well-tolerated and effective antihypertensive agent, and did not reduce regional cerebral blood flow in elderly hypertensive patients.