氯沙坦与吲哒帕胺单用和两药联合治疗老年高血压疗效比较

目的观察氯沙坦与吲哒帕胺单独应用或联合用药对原发性高血压患者血压、血钾、血糖、尿酸、血脂的影响。方法将符合诊断标准的150例老年高血压患者电脑随机分为3组，每组50例，进行用药前后自身对照试验，8周后检测各组血压、血钾、血糖、尿酸、血脂值。结果3组治疗后收缩压和舒张压均较前明显降低，联合治疗组降压幅度最大，氯沙坦组和联合治疗组治疗后尿酸值较治疗前降低，吲哒帕胺组治疗后血钾值较治疗前降低。结论氯沙坦与吲哒帕胺联合应用不仅具有协同降压作用，而且能降低尿酸，减轻吲哒帕胺引起的低钾血症。     

Solid-state compatibility screening of excipients suitable for development of indapamide sustained release solid-dosage formulation

Differential scanning calorimetry and Fourier transform infrared spectroscopy were applied as screening analytical methods to assess the solid-state compatibility of indapamide (4-chloro-N-(2-methyl-2,3-dihydroindol-1-yl)-3-sulfamoyl-benzamide) with several polymers aimed for development of 24?h sustained release solid-dosage formulation. After the initial research phase which was directed towards selection of suitable polymer matrices, based on their solid-state compatibility with the studied pharmaceutical active ingredient, the second phase of evaluation was intended for compatibility selection of other excipients required to complete a sustained release formulation. The preformulation studies have shown that polyvinylpyrrolydone/polyvinyl acetate might be considered incompatible with indapamide, and the implementation of this polymer career should be avoided in the case of the entitled development. The experimental data additionally have revealed that sorbitol is incompatible with indapamide. The obtained results afforded deeper insight in to the solid-state stability of the studied binary systems and pointed out directions for further development of indapamide sustained release solid-dosage formulation.     

Perindopril/indapamide combination in the first-line treatment of hypertension and end-organ protection

This article examines evidence-based findings in the literature on the efficacy of perindopril 2 mg/indapamide 0.625 mg, a first-line, low-dose antihypertensive drug combination. In regulatory Phase II and III trials, perindopril/indapamide significantly lowered blood pressure compared with other first-line therapies (atenolol, losartan and irbesartan). This was also the case in STRAtegies of Treatment in Hypertension: Evaluation, a postregistration study versus current monotherapies and stepped-care therapy with different classes of antihypertensive agents. The efficacy/safety ratio (both clinical and with regard to laboratory parameters) of perindopril/indapamide was good. Perindopril/indapamide provides additional antihypertensive efficacy compared with each component used alone and with current monotherapies, with major efficacy on systolic blood pressure, an important predictor of cardiovascular risk. It also reduces pulse pressure, an independent cardiovascular risk factor, large-vessel arterial stiffness and microcirculatory alterations. The fixed dosage of a once-daily tablet, ensures optimal ease of use and enhances patient compliance. Perindopril/indapamide also reduces target organ damage in patients at high cardiovascular risk, such as patients with cardiac hypertrophy and Type 2 diabetics with albuminuria. These benefits, together with the good efficacy/tolerability ratio, fulfill the requirements of the European Society of Hypertension and of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines for low-dose, first-line combination therapy in hypertension.     

缬沙坦或吲达帕胺对中青年男性高血压患者性功能影响

目的　探讨缬沙坦和吲达帕胺对中青年男性高血压患者降压的疗效以及对性功能的影响。方法　将入选的 12 0例患者随机分为两组 ,一组服用缬沙坦 ,另一组服用吲达帕胺 ,观察治疗 8周前后血压及性功能变化。结果　缬沙坦和吲达帕胺均能显著降压 (P <0 0 1)。缬沙坦治疗后明显增加了勃起功能指数 (17.7± 4 6vs 14± 5 6 ,P <0 0 1)和每周性交次数 (3 2± 1 2次 /周vs 2 2±1 1次 /周 ) ,两者差异显著 (P <0 0 1) ;而吲达帕胺治疗前后患者性功能无明显改变 (P >0 0 5 )。结论　缬沙坦在降压的同时能显著改善男性性功能。     

吲哒帕胺对高血压高危患者血清肌酐、尿酸、血钾及左室肥厚的长期影响

目的　观察吲哒帕胺 (寿比山 )在高血压高危患者中长期应用时SCr、UA、血钾的变化 ,以及合用血管紧张素转换酶抑制剂 (ACEI)能否减轻这些变化。方法　吲哒帕胺组 (Ⅰ组 ) 182例 ,给予吲哒帕胺 2 .5mg/d口服 ,如 2～ 4周后未达到目标血压 (<14 0 / 90mmHg)则加用ACEI苯那普利 (10mg/d)或卡托普利 (2 5～ 75mg/d)。对照组 (C组 )2 10例 ,给予钙拮抗剂 (硝苯地平 30mg/d或非洛地平 5mg/d)或 /和ACEI(苯那普利 10mg/d或卡托普利 2 5～ 75mg/d) ,治疗前后测定SCr、UA、血钾、血脂和血糖并做心超测定左室重量指数。结果　Ⅰ组SCr、UA明显升高 ;Ⅰ组有 7例SCr>2 5 0 μmol/L(而C组为 3例 ,3.8%vs 1.4 % ,P <0 0 5 ) ;7例因UA明显升高而诱发痛风 ;血钾明显降低 (P <0 0 0 1) ,低血钾发生率 14 .8% (C组仅 1.4 % ,P <0 0 0 1)。在Ⅰ组中 ,吲哒帕胺与ACEI合用者与单用吲哒帕胺者相比 ,SCr和UA升高的幅度及血钾降低的幅度明显降低 (P <0 0 1) ,低血钾的发生率亦明显减少 (5 .8%vs 2 5 .3% ,P<0 0 1)。Ⅰ组和C组伴LVH者的LVMI分别减轻 10 8%和 11.5 %。Ⅰ组单用吲哒帕胺的有效降压 (BP <14 0 / 90mmHg)率为 4 9.2 % ,加用ACEI后提高到 85 .3%。结论　吲哒帕胺降压作用肯定 ,长期服用能减轻高血压左室肥厚 ,对     

吲哒帕胺联合厄贝沙坦治疗老年期高血压对照研究

目的探讨吲哒帕胺联合厄贝沙坦治疗老年期高血压患者的临床疗效及安全性。方法将96例老年期高血压患者随机分为两组各48例，两组均晨口服吲哒帕胺治疗，治疗组联合厄贝沙坦治疗，观察6w。于治疗前及治疗6w末依据疗效判定标准评定两组临床疗效，并进行对比分析。结果治疗6w末，两组收缩压和舒张压均较治疗前有显著性下降（P〈0．01）；治疗组总有效率为93．75％，对照组为75．0％，治疗组显著高于对照组（P〈0．05）；不良反应发生率低于对照组，但无显著性差异（P〉0．05）。结论吲哒帕胺联合厄贝沙坦治疗老年期高血压病较单用吲哒帕胺治疗效果更显著，且安全性更高，依从性更好。     

LOW DOSE INDAPAMIDE PLUS PERINDOPRIL COMBINATION EFFECTS ON CARDIOVASCULAR STRUCTURE AND FUNCTION IN GENETIC HYPERTENSION

1. Although the fixed combination preparations of thiazide and angiotensin-converting enzyme inhibitor are gaining wide acceptance in clinical practice, data on the basic pharmacology of the combinations are relatively limited. The long-term structural and functional effects of a fixed low dose (0.24 + 0.76 mg/kg per day) combination of indapamide + perindopril (I + P,S5590) is spontaneously hypertensive rats (SHR) were examined in the present study. 2. Male SHR (10-12 weeks) were treated with I + P or vehicle for 8 weeks. The blood pressure and heart rate were monitored by weekly measurements. At the end of the treatment period, left ventricular, aortic and intramyocardial coronary arteriole structures were assessed. Contractile and relaxant properties of mesenteric arteries were determined by wire-myography. 3. Indapamide + perindopril combination caused a significant lowering of both systolic (P < 0.001) and diastolic (P < 0.001) blood pressures. Left ventricle plus septum:bodyweight ratio (P < 0.001), aortic medial cross-sectional area (P < 0.05) and media:lumen ratios (P < 0.005) were all significantly reduced by I + P treatment. In contrast, the effect of I + P on intramyocardial coronary vascular structure did not reach statistical significance. There was some improvement in endothelium-independent vasorelaxation of mesenteric vessels but contractile responses to noradrenaline and calcium were unaffected by treatment. 4. In summary, a low dose I + P combination treatment of SHR partly normalizes both systolic and diastolic blood pressures. Cardiac and larger vessel hypertrophy was reversed but intramyocardial coronary arteriole structure was not as readily regressed by the end of the study.     

氯沙坦、培哚普利及联用吲哒帕胺治疗老年1、2级原发性高血压的疗效比较

目的 :评价氯沙坦、培哚普利及联用吲哒帕胺治疗老年 1、2级原发性高血压的临床疗效和安全性。方法 :77例老年 1、2级原发性高血压患者随机分为两组 :氯沙坦组 (n=3 8)用氯沙坦 5 0 mg/d;培哚普利组 (n=3 9)用培哚普利4mg/d,4周后未达目标血压 (<18.7/12 k Pa)者加用吲哒帕胺 2 .5 mg/d。结果 :经 8周治疗 ,两组药物均有显著的降压作用 (P<0 .0 1) ,氯沙坦组达标率 86.8% ,培哚普利组达标率 87.1% (P<0 .0 5 )。氯沙坦组和培哚普利组分别有 17例和 16例加用吲哒帕胺 (P>0 .0 5 )。两组不良反应发生率无显著性差别。结论 :氯沙坦和培哚普利治疗老年 1、2级高血压安全有效 ,与吲哒帕胺联用 ,能有效治疗氯沙坦或培哚普利单药治疗无效者     

吲达帕胺及(或)非洛地平对老年高血压患者动态血压的影响

目的探讨降压药物吲达帕胺缓释片联合非洛地平缓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150例,平均年龄(65±4)岁,按就诊顺序随机分3组:分别给予吲达帕胺缓释片1.5mg/d、非洛地平缓释片5mg/d和吲达帕胺缓释片1.5mg/d+非洛地平缓释片5mg/d,疗程3个月。观察治疗前后24h、白昼及夜间平均收缩压/舒张压和平均收缩压/舒张压负荷以及平均心率。结果治疗结束时3组24h、白昼和夜间平均收缩压/舒张压均较服药前明显下降;血压负荷值亦明显减少;而联合治疗组与单药治疗组比较下降更明显,差异具有统计学意义。治疗前后心率没有明显变化。结论小剂量长效利尿剂联合钙拮抗剂治疗高血压疗效显著,稳定性好,不良反应少。老年高血压病患者应尽量选择长效利尿剂联合钙拮抗剂。     

吲哒帕胺联合施慧达治疗老年单纯收缩期高血压疗效观察

目的 观察小剂量吲哒帕胺联合施慧达对老年单纯收缩期高血压（ISH）的降压疗效及其对左心室肥厚的影响.方法 将服用小剂量吲哒帕胺收缩压未降至140 mmHg以下的103例老年ISH患者随机分为两组,施慧达组51例患者加服施慧达,2.5 mg/d,对照组52例患者根据病情选用降压药物,治疗前后做24h动态血压、舒张末期室间隔厚度、舒张末期左心室后壁厚度、舒张末期左心室内径测定.结果 施慧达组患者的收缩期血压达标率及有效逆转左心室肥厚优于对照组,差异有统计学意义（P＜0.05）.结论 小剂量吲哒帕胺与施慧达联合应用可有效降低血压,逆转左心室肥厚.