卡托普利三联小剂量对老年高血压左室肥厚及左室舒张功能的影响

目的探讨卡托普利三联小剂量对老年轻、中度原发性高血压（EH）合并左室肥厚（LVH）及左室舒张功能不全的疗效及安全性。方法72例老年轻、中度EH合并LVH及其舒张功能不全的患者，随机分为三联小剂量组：给予卡托普利25mg／d，氢氯噻嗪12．5mg／d，氨氯地平2．5-5．0mg／d，晨顿服；二联常规剂量组：给予卡托普利50mg／d，氢氯噻嗪25mg／d，晨顿服。疗程均为半年，均于药物治疗前、后监测血压、LVH及左室舒张功能变化。结果三联小剂量组在降压疗效（94．44％）、逆转LVH和改善左室舒张功能的各项指标。均明显优于二联常规剂量组（P〈0.05）。结论两组均可降低老年EH，逆转LVH和改善左室舒张功能，且小剂量的三药联用效果大于双倍剂量的二药联用。

Efficacy of low-dose captopril triple therapy for left ventricular hypertrophy and left ventricular diastolic function in aged patients with essential hypertension

Objective] To find out the efficacy and safety of low-dose captopril triple therapy for left ventricular hypertrophy and left ventricular diastolic function in aged patients with mild or middle type essential hypertension. Methods] 72 aged patients with mild or middle type essential hypertension and left ventricular hypertrophy and left ventricular diastolic function were divided into two groups randomly, the low-does captopril triple therapy group (I) and the two drugs combination group (II): group I was given captopril 25 mg, hydrochlorothiazide 12.5 mg and amlodipine 2.5~5.0 mg per day in the morning, group II was given captopril 50 mg and hydrochlorothiazide 25 mg per day in the morning. The course of treatment was half a year. The indexes of the observation included the variety of blood pressure, left ventricular hypertrophy and left ventricular diastolic function after six months treatment in both groups. Result] It was found that the efficacy of group I was significantly better than group II in decreasing the blood pressure (94.44%) and reversing the left ventricular hypertrophy and improving left ventricular diastolic function (P <0.05). Conclusion] Both of the treatments can decrease the blood pressure and reverse the left ventricular hypertrophy and improve left ventricular diastolic function. But the efficacy of the low-does captopril triple therapy group is much better than the two drugs combination group.