动态血压监测评价复方替米沙坦的降压疗效

目的以24 h动态血压监测评价复方替米沙坦治疗轻中度原发性高血压患者的疗效。方法选择28例轻中度高血压患者,予以复方替米沙坦1~2片(每片含替米沙坦40 mg,氢氯噻嗪12.5 mg),po,qd,治疗8 wk,分别于治疗前后行24 h动态血压监测并计算其谷峰比值、平滑指数后进行比较分析。结果治疗8 wk后24 h平均收缩压、舒张压,日间平均收缩压、舒张压,夜间平均收缩压、舒张压与治疗前比较均有显著性降低(P<0.01),收缩压、舒张压负荷也有显著降低(P<0.01)。收缩压谷峰比值为62.4%,舒张压谷峰比值为65.6%,收缩压平滑指数为1.08±0.36,舒张压平滑指数为1.13±0.22。结论复方替米沙坦具有良好的降压效果及满意的谷峰比值、平滑指数,临床使用安全。     

非洛地平缓释片治疗原发性高血压临床研究

目的研究非洛地平缓释片治疗轻中度原发性高血压患者的谷峰比值和平滑指数。方法对28例轻中度高血压患者,口服非洛地平缓释片5mg,每天1次,疗程8周,于治疗前后进行24h动态血压监测并计算其谷峰比值和平滑指数。结果治疗8周后,24h收缩压和24h舒张压、白昼收缩压和舒张压、夜间收缩压和舒张压与治疗前比较均有非常显著性差异(P<0.001),T/P为收缩压69%,舒张压70%。平滑指数为收缩压(1.09士0.57),舒张压(0.94士0.51)。结论非洛地平缓释片有较高的T/P比值及良好的平滑指数。     

小剂量阿罗洛尔联合左旋氨氯地平对中青年高血压的降压疗效观察

目的 24h动态血压监测（ABPM）评价小剂量阿罗洛尔联合左旋氨氯地平对中青年轻中度高血压患者的降压效果及糖脂代谢的影响。方法选择中青年轻中度原发性高血压患者,口服小剂量阿罗洛尔5mg,2次/d和左旋氨氯地平2.5mg,1次/d,在服药前及服药8周后分别记录24h平均血压、白天平均血压、夜间平均血压并进行比较,计算患者用药前后24 h收缩压、舒张压平滑指数和谷峰比值,观察两种药物联合降压疗效和耐受性。结果共完成试验68例,治疗8周后24h平均血压、白天平均血压、夜间平均血压明显低于治疗前,差异有统计学意义（P〈0.05）;谷峰比值为收缩压74%,舒张压72%。平滑指数为收缩压（1.49±0.38）mmHg,舒张压（1.43±0.40）mmHg;对患者血糖、血脂及其他生化指标无不良影响。结论小剂量阿罗洛尔联合左旋氨氯地平对中青年轻中度高血压患者的降压效果显著,降压平稳,而且不良反应少,为理想的联合降压方案之一。     

血压平滑指数与谷峰比值评价苯磺酸左旋氨氯地平降压作用

目的 利用血压平滑指数与谷峰比值观察左旋氨氯地平对轻中度原发性高血压患者的降压作用.方法 选取2008年9月～2010年6月期间该院就诊的轻中度原发性高血压患者98例给予苯磺酸左旋氨氯地平2.5 mg,每天1次,服用8周.用药前和用药8周后分别行24 h动态血压监测,计算患者用药前后24 h收缩压、舒张压平滑指数和谷峰...     

替米沙坦对原发性高血压患者偶测血压及动态血压的影响

目的 观察替米沙坦对轻中度原发性高血压患者偶测血压和动态血压的影响，评价替米沙坦降血压疗效。方法 43例轻中度原发性高血压患者，经历1周清洗期后给予替米沙坦40 mg·d^-1，po，qd，疗程为8周，测定治疗后偶测血压，并用24 h动态血压测定用药前后血压变化及降压谷峰比（T/P）。结果 替米沙坦治疗轻中度原发性高血压总有效率为79.1%，用药后全天血压均值、白天血压均值、夜间血压均值、给药末4 h平均血压均明显下降( P＜0.01)，收缩压的谷峰比为68.4%，舒张压的谷峰比为79.3%。结论 替米沙坦治疗轻中度原发性高血压有显著的疗效，降血压作用可持续24 h，适合每天一次服用。     

替米沙坦与咪达普利对高血压患者血压变异性的影响

目的 比较替米沙坦与咪达普利对高血压患者血压变异性的影响.方法 选择80例原发性高血压患者随机分为两组(替米沙坦组和咪达普利组),每组各40例,分别服用替米沙坦40 mg/d、咪达普利5 mg/d,共治疗8周.比较治疗前和治疗8周后动态血压和血压变异性的情况.结果 与治疗前比较,沙坦组、普利组治疗后两组患者24 h平均收缩压、24h平均舒张压、白昼平均收缩压、白昼平均舒张压均下降,差异有统计学意义(P＜0.05).替米沙坦组治疗后血压变异性明显减小(P＜0.05),两组间相比替米沙坦组更能有效地降低患者白昼和夜间血压变异性(P＜0.05).结论 对于原发性高血压患者,替米沙坦与咪达普利白昼的降压疗效相当;替米沙坦在改善血压昼夜节律,降低血压变异性方面优于咪达普利.     

硝苯地平控释片治疗老年原发性高血压动态血压的疗效观察

目的采用24h动态监测方法观察硝苯地平控释片在老年高血压患者中的降压效果。方法选择老年高血压病患者60例,每日口服硝苯地平控释片30～60mg,共8周。记录治疗前后24h、昼间及夜间平均收缩压/舒张压和平均收缩压/舒张压负荷;以及平均心率、谷峰比值。结果治疗结束时24h、昼间和夜间平均收缩压/舒张压均较服药前明显下降（P〈0.01）,分别下降（14.9±4.8）/（8.7±4.7）mmHg、（15.7±5.5）/（8.2±3.5）mmHg、（13.9±4.5）/（8.2±3.8）mmHg;血压负荷值亦明显减少（P〈0.01）;治疗前后心率无明显变化;谷峰比为收缩压84.2%,舒张压81.6%。结论硝苯地平控释片治疗高血压疗效显著,稳定性好,可持续24h。     

坎地沙坦酯对高血压谷峰比值、平滑指数的影响

目的探讨坎地沙坦酯治疗轻中度原发性高血压的疗效及对患者血压谷峰比值和平滑指数的影响。方法50例轻中度原发性高血压患者,口服坎地沙坦酯8mg,每天1次,疗程4周,于治疗前后进行24h动态血压监测并计算其谷峰比值（T／P）和平滑指数。结果治疗4周后,24h平均收缩压（148．2±10．7）mmHg和24h平均舒张压（97．6±6．5）mm Hg、白昼平均收缩压（152．5±9．8）mm Hg和平均舒张压（96．0±5．3）mmHg、夜间平均收缩压（138．3±7．6）mmHg和平均舒张压（89．2±8．3）mmHg、收缩压负荷值（87．5±12．2）％和舒张压负荷值（36．48±26．4）％与治疗前的（130．2±7．2）mmHg、（79．5±7．8）mm Hg、（133．4±7．2）mmHg、（81．8±6．6）mmHg、（121．9±7．3）mmHg、（72．1±7．4）mmHg、（84．7±9．9）％、（26．7±8．3）％比较差异均有统计学意义（均P〈0．01）;治疗后收缩压和舒张压T／P分别为70％和63％、平滑指数分别为（1．21±0．82）和（1．13±0．51）,均符合要求。结论坎地沙坦酯治疗原发性高血压安全有效,均能获得良好的T／P比值及平滑指数。     

替米沙坦联用氢氯噻嗪治疗轻中度高血压的临床研究

目的:评估国产替米沙坦片联用氢氯噻嗪片治疗轻中度高血压的有效性和安全性。方法:152例轻中度原发性高血压患者经2周安慰剂洗脱期后,用替米沙坦40mg治疗4周,4周末单剂治疗无效的72例患者接受替米沙坦40mg和氢氯噻嗪12．5mg治疗8周。在洗脱期末(0周)、替米沙坦单剂治疗末(4周末)和替米沙坦联用氢氯噻嗪8周末(12周末),进行诊室血压(CBP)、心电图、血生化指标、24h动态血压监测(ABPM)、脉搏波传导速度(PWV)和超声心动图检测。结果:12周末与4周末比较,诊室收缩压(CSBP)和诊室舒张压(CDBP)均显著降低(P＜0．001),降压幅度达16．70/15．28mmHg,总有效率91．67%,不良事件发生率9．7%;24h平均收缩压和舒张压均显著降低(P＜0．001),降幅为8．41/6．21mmHg,24h平均脉压(PP)也显著降低,降幅为4．60 mmHg,白昼及夜间血压及血压负荷值均显著降低(P＜0．05),12周末收缩压谷峰比为72．66%,舒张压谷峰比为76．21%。4周末, PWV显著降低[(11．17±1．83)vs(10．19±1．44)m·s~(-1),P＜0．05],舒张早期血流峰值流速(E峰)与舒张晚期血流峰值流速(A峰)的比值(E/A)显著增加、左室等容舒张时间(IVRT)显著缩短,左室重量指数(LVMI)也显著改善(P＜0．05)。12周末,PWV进一步降低至(9．24±1．01)m·s~(-1)(P＜0．001),舒张功能显著改善(P＜0,01), LVMI也显著降低(P＜0．001)。结论:国产替米沙坦片40mg联用氢氯噻嗪片12．5mg对于替米沙坦40mg单剂治疗4周无效的轻中度高血压患者安全有效。     

国产硝苯地平控释片降压效果动态血压分析

目的:观察国产硝苯地平控释片的降压效果。方法:82例原发性高血压(EH)患者每天服用国产硝苯地平控释片30～60mg,疗程4～8周,均以24 h动态血压作为监测及评价方法。结果:24 h收缩压和舒张压均明显下降(P<0.01),收缩压谷峰比=89%,舒张压谷峰比=82%,对夜间血压不产生过度降压作用,对血糖、血脂、血尿酸无影响,不良反应发生率低。结论:每日服用30～60 mg国产硝苯地平控释片对EH有24 h平稳降压作用。     

监测48小时动态血压评估替米沙坦对轻、中度原发性高血压的疗效

目的观察替米沙坦48h血压控制的效果和对动脉硬化指数(AASI)的影响。方法轻、中度原发性高血压患者71例,经过2wk的清洗期后接受口服替米沙坦,80mg,qd,治疗8wk。治疗前接受24h动态血压监测,治疗8wk后接受48h动态血压监测,比较治疗前后血压以及AASI的变化。结果完成有效病例数60例。治疗8wk时,末次服药后d1的平均SBP和DBP分别为(134±s14)mmHg、(87±8)mmHg,末次服药后d2的平均SBP和DBP分别为(135±14)mmHg、(88±8)mmHg,均比治疗前[(141±14)mmHg、(92±8)mmHg]显著下降(P<0.01);治疗的总有效率为60%(36/60),末次服药后d2有效率仍达50%(30/60)。对治疗有效的病例进行分析:SBP和DBP下降的平滑指数(SI)分别为1.02和0.89;清晨高血压患者的比例治疗前69%(25/36),治疗后下降至39%(14/36)(P<0.01),而所有患者夜间平均DBP均在60mmHg以上。治疗后AASI有下降趋势,但无显著差异(0.48±0.15vs.0.44±0.18,P>0.05),AASI的变化与脉压的改变密切相关。结论替米沙坦80mg能够持续48h控制轻、中度原发性高血压,降低清晨高血压,夜间血压无过度下降,对AASI的影响尚需进一步随访观察。     

替米沙坦治疗轻中度高血压患者降压效果及其安全性

目的:观察替米沙坦治疗轻、中度高血压病的临床降压效果。方法:72例临床确诊为轻、中度高血压病者,随机分为替米沙坦组(35人)和氯沙坦组(37人),分别每日早晨服替米沙坦80mg,或氯沙坦50mg,总观察时间为8周。服药后第4、8周测定血压,入选时与服药后第8周测定血钾、肝功能、肾功能。结果:服药第4周、第8周两观察组血压均较观察前显著降低(P<0.05,P<0.01),且替米沙坦的降压作用较氯沙坦明显(P<0.01,P<0.001)。到第8周末,替米沙坦组与氯沙坦组降压总有效率分别达94.1%与88.6%。与观察开始前比较,第8周末血钾、肝功能、肾功能无明显改变。结论:替米沙坦对轻、中度高血压病患者有良好的降压效果,服用安全。     

Telmisartan/hydrochlorothiazide combination therapy in the treatment of essential hypertension

Telmisartan is an angiotensin-II receptor blocker that has demonstrated efficacy in the reduction of blood pressure in patients with hypertension. Patients with hypertension commonly require two or more antihypertensives to reduce their blood pressure to safe levels, and the choice of combination therapy should be informed by clinical trial data. Telmisartan is available in fixed-dose combination with hydrochlorothiazide (telmisartan/HCTZ) in doses of 40 mg/12.5 mg and 80 mg/12.5 mg. Telmisartan/HCTZ has been studied in a number of clinical trials in essential hypertension, for the most part using ambulatory blood pressure monitoring. It has been compared with monotherapy in full patient populations and in non-responders, and has been compared with other drug combinations. Telmisartan/HCTZ provides significantly greater reductions in blood pressure than monotherapy, and significantly increases the percentage of patients who achieve target blood pressure. The reduction in blood pressure achieved by adding HCTZ to telmisartan is greater than that achieved by adding HCTZ to atenolol, despite the fact that telmisartan and atenolol monotherapy had similar efficacy. Telmisartan/HCTZ provides significantly greater reductions than losartan plus HCTZ in 24-h mean blood pressure, primarily due to a significantly greater effect in the risky, early morning hours. Telmisartan/HCTZ is effective and well-tolerated in the elderly, diabetics and African-American patients. Ongoing studies are comparing the efficacy of telmisartan/HCTZ with valsartan plus HCTZ and amlodipine plus HCTZ in overweight, hypertensive diabetics and in patients with isolated systolic hypertension - two patient groups who are particularly at risk of target organ damage.     

Telmisartan/hydrochlorothiazide combination therapy in the treatment of essential hypertension

Telmisartan is an angiotensin-II receptor blocker that has demonstrated efficacy in the reduction of blood pressure in patients with hypertension. Patients with hypertension commonly require two or more antihypertensives to reduce their blood pressure to safe levels, and the choice of combination therapy should be informed by clinical trial data. Telmisartan is available in fixed-dose combination with hydrochlorothiazide (telmisartan/HCTZ) in doses of 40 mg/12.5 mg and 80 mg/12.5 mg. Telmisartan/HCTZ has been studied in a number of clinical trials in essential hypertension, for the most part using ambulatory blood pressure monitoring. It has been compared with monotherapy in full patient populations and in non-responders, and has been compared with other drug combinations. Telmisartan/HCTZ provides significantly greater reductions in blood pressure than monotherapy, and significantly increases the percentage of patients who achieve target blood pressure. The reduction in blood pressure achieved by adding HCTZ to telmisartan is greater than that achieved by adding HCTZ to atenolol, despite the fact that telmisartan and atenolol monotherapy had similar efficacy. Telmisartan/HCTZ provides significantly greater reductions than losartan plus HCTZ in 24-h mean blood pressure, primarily due to a significantly greater effect in the risky, early morning hours. Telmisartan/HCTZ is effective and well-tolerated in the elderly, diabetics and African-American patients. Ongoing studies are comparing the efficacy of telmisartan/HCTZ with valsartan plus HCTZ and amlodipine plus HCTZ in overweight, hypertensive diabetics and in patients with isolated systolic hypertension – two patient groups who are particularly at risk of target organ damage.     

Telmisartan/Hydrochlorothiazide: a review of its use as fixed-dose combinations in essential hypertension

Fixed-dose combinations of telmisartan and hydrochlorothiazide (HCTZ) [Micardis Plus((R)), Micardis((R)) HCT, PritorPlus((R))] are available in many countries for the treatment of patients with essential hypertension. Combining the angiotensin II receptor antagonist (angiotensin II receptor blocker [ARB]) telmisartan with the thiazide diuretic HCTZ provides antihypertensive therapy with complementary mechanisms of action. In the US and EU, telmisartan/HCTZ is approved for patients whose hypertension is not adequately controlled with telmisartan monotherapy; US labelling for the fixed-dose combination also includes inadequate control of blood pressure (BP) with HCTZ monotherapy.The antihypertensive efficacy of once-daily telmisartan/HCTZ has been demonstrated in several large, randomized trials in patients with stages 1 and 2 hypertension. The addition of HCTZ to telmisartan achieved significant reductions in BP in nonresponders to telmisartan monotherapy, and the antihypertensive efficacy of telmisartan/HCTZ was similar to or significantly greater than that of various comparator agents. Moreover, in studies that used ambulatory BP monitoring, telmisartan/HCTZ provided consistent 24-hour BP reductions throughout morning, daytime and night-time periods. The BP-lowering efficacy over the entire 24-hour dose administration interval is consistent with the pharmacokinetic profile of telmisartan, which has the longest elimination half-life among currently available ARBs and a unique chemical structure. Adverse events with telmisartan/HCTZ in clinical trials were typically mild and transient, and no unexpected events occurred that had not been previously reported with either telmisartan or HCTZ. Extensive tolerability data are available for telmisartan, in particular from the ONTARGET study, the largest clinical outcomes trial with an ARB. As such, fixed-dose combinations of telmisartan/HCTZ provide an effective, rational and generally well tolerated treatment option for the management of patients with hypertension.     

Once-daily lisinopril compared with twice-daily captopril in the treatment of mild to moderate hypertension: assessment of office and ambulatory blood pressures

This multicenter, double-blind, parallel-group study compared the antihypertensive effects of two angiotensin-converting enzyme inhibitors, lisinopril and captopril, in 70 patients (35 lisinopril, 35 captopril) with mild-to-moderate essential hypertension. Doses of 10, 20, and 40 mg once-daily lisinopril or 25, 50, and 100 mg bid captopril were increased at biweekly intervals until patients responded to treatment, as defined by a decrease in office diastolic pressure to less than 90 mm Hg or at least a 10 mm Hg decrease from baseline. Patients who responded to a 2-week titration dose remained at that dose for another 2 weeks. Blood pressure assessments were made using both office and ambulatory blood pressure monitoring. Area under the curve analysis of ambulatory blood pressure reductions showed significant differences between treatment groups for both systolic (P = .023) and diastolic (P = .007) blood pressures, with lisinopril-treated patients showing the most significant reduction in pressure. Greater reductions (P less than .05) were also noted in patients receiving lisinopril at hours 10 to 12, suggesting two blood pressure troughs for those receiving captopril. Both drugs were well tolerated, and no patients withdrew from either treatment group. The authors concluded that after at least 4 weeks of therapy, once-daily lisinopril administration was more effective than twice-daily captopril administration in reducing blood pressure, when measured by 24-hour ambulatory blood pressure monitoring.     

国产苯磺酸氨氯地平治疗轻中度高血压的疗效观察

目的探讨国产苯磺酸氨氯地平（压氏达）治疗167例单纯轻中度高血压患者的疗效及安全性。方法选择2008～2011年门诊诊治的单纯轻中度原发性高血压患者167例，观察服药前、服药后1、2、3、4、5、6、7、8周血压情况及不良反应，用药前、用药后4、8周检测24h动态血压。结果用药1周后血压均明显下降，与用药前比较，差异有统计学意义（P〈0．05）。疗程结束后其总有效率为87．4％，男女间差异无统计学意义（P〉0．05）。1周后降压作用持续、稳定，24h动态血压印证了这一结果，用药前后平均收缩压、舒张压均明显下降，差异有统计学意义（P〈0．05），且服药4、8周谷峰比分别为53．6％、52．4％。在不良反应方面以头痛、足踝水肿为主，但发生率均较低，分别为3．6％、4．8％。结论国产苯磺酸氨氯地平降压安全有效，作用持久，且具备价格优势，值得临床推广。     

老年高血压患者血压变异性比较

目的:探讨老年高血压患者血压变异性的差别.方法:选择原发性高血压84例,进行动态血压监测(ABPM),血压变异性以24 h ABPM监测到的血压标准差(S)作为长时血压变异(LBPV)的指标.结果:84例老年高血压患者白昼、夜间及24小时的收缩压的变异性均大于舒张压的变异性,两者有统计学意义(P＜0.05).结论:老年高血压患者收缩压的血压变异性大于舒张压的血压变异性.     

珍菊降压片早、中二次投药的降压效果

目的以24h动态血压监测（ABPM）评价珍菊降压片早、中二次投药治疗轻中度原发性高血压患者的疗效。方法80例轻中度高血压患者随机分为试验组40例和对照组40例。试验组口服珍菊降压片早晨2片,中午1片;对照组口服珍菊降压片1片,每天3次。治疗8周。分别于治疗前后行24hABPM。结果2组24hABPM参数均较用药前显著下降（P〈0.01）;降压总有效率试验组为90.0%,对照组87.5%,2组比较差异无统计学意义（P〉0.05）。3例夜间血压最低值均出现在对照组。结论珍菊降压片降压效果良好。早、中2次投药,可防止夜间靶器官缺血。     

替米沙坦用于老年高血压患者降压效果的动态监测

目的 动态监测替米沙坦治疗老年高血压患者的效果.方法 选择2010年10月-2012年12月我院收治的老年高血压患者140例,应用替米沙坦80mg治疗6周后,比较治疗前后动态血压变化情况.结果 治疗后白天收缩压和舒张压的最高血压、平均血压、血压负荷均低于治疗前,差异均有统计学意义（P＜0.05）;治疗后夜间收缩压和舒张压的最高血压、平均血压、血压负荷均低于治疗前,差异均有统计学意义（P＜0.05）.结论 替米沙坦降血压具有持久、强效、平稳、安全的特点,值得临床推广应用.