应用动态血压监测评价氯沙坦治疗原发性高血压的降压疗效

目的：应用动态血压监测（ＡＢＰＭ）评估氯沙坦（ｌｏｓａｒｔａｎ）５０～１００ ｍｇ，每日１次，对轻、中度原发性高血压（ＥＨ）患者的２４小时降压效果。 方法：轻、中度ＥＨ患者 ３３例，服用 ２周安慰剂，坐位舒张压仍在 ９５～１１４ ｍｍＨｇ（１ ｍｍＨｇ＝０．１３３ ｋＰａ）者予氯沙坦５０ ｍｇ／ｄ，服药 ２周末血压下降未达有效标准者氯沙坦增加至 １００ ｍｇ／ｄ，氯沙坦治疗疗程共 ６周。于服安慰剂末及治疗２、４、６周末测诊室血压，于服安慰剂末及治疗６周末应用ＡＢＰＭ。 结果；氯沙坦治疗６周，降压总有效率为８７．５％；２４小时各时点血压均较治疗前显著下降（Ｐ＜０．０５、Ｐ＜０．０１），不伴有心率及血压昼夜节律的改变；降低收缩压和舒张压的谷／峰值分别为５２．９％和６３．６％。能明显降低血尿酸（Ｐ＜０．０５）。除１例因头晕中途退出研究外，余不良反应轻微。 结论：氯沙坦 ５０～１００ ｍｇ，每日１次能平稳、有效地控制 ＥＨ患者 ２４小时血压，且患者总体耐受良好。

Evaluation of Antihypertensive Effect of Losartan by Ambulatory Blood Pressure Monitoring

Objective:To evaluate the efficiency of losartan for Chinese patients with mild to moderate hypertension by ambula- tory blood pressure monitoring(ABPM). Method: Thirty-three patients with mild to moderate hypertension Lsitting diastolic blood pressure of 95 - 114 mmHg(1 mmHg= 0. 133 kpa)] were recruited. After 2-week placebo run-in period,they were treated with losartan 50- 100 mg/d for 6 weeks,and ABPM was taken before and after 6-week treatment. Results: Losartan had a total effective rate of 87. 5% and exerted its antihypertensive effect throughout 24 hour dose-interval without alternation of heart rate and blood pressure circadian(p<0. 05. 0. 01). Besides,T/P ratio of sys- tolic pressure and diastolic pressure were larger than 50%. Laboratory examination showed the blood uric acid was low- ered by losartan (p<0. 05). The side effect was few and mild except for 1 patient who quitted the study halfway because of the head swirling. Conclusion:Losartan 50-100 mg once daily can effectively control the blood pressure throughout 24 hour in mild to moderate essential hypertension and it is well tolerated.