依普罗沙坦与氯沙坦在轻中度原发性高血压病人中的降压疗效比较

目的:以氯沙坦为对照,观察依普罗沙坦治疗轻、中度原发性高血压(EH)病人的疗效与安全性。方法:采用前瞻性、随机、双盲、阳性药对照研究。符合方案的50例轻、中度EH病人经筛选期(2 wk)、安慰剂导入期(2 wk)后,随机分为依普罗沙坦组(n=24)与氯沙坦组(n=26)。在治疗期,2组病人分别每日1次口服依普罗沙坦600 mg或氯沙坦50 mg。若4 wk血压不达标,即坐位舒张压(DBP)≥90 mmHg (1 mmHg=0．133 3 kPa),加氢氯噻嗪12．5 mg,每日1次口服至8 wk。观察治疗前、治疗后4 wk与8 wk血压、心率以及治疗前后血、尿常规,血生化及心电图改变。结果:在治疗后8 wk,依普罗沙坦组的收缩压(SBP)与DBP分别下降了(12±s 10)mmHg与(12±5)mmHg,氯沙坦组的降压幅度分别为(14±9)mmHg与(10±6)mmHg,治疗前后比较有非常显著差异(P<0．01);但2组间血压下降的幅度无显著差异(P>0．05)。依普罗沙坦组与氯沙坦组的降压总有效率分别为100％和8l％,2组疗效无显著差异(P>0．05)。依普罗沙坦组加用氢氯噻嗪病例为9例(38％),而氯沙坦组为6例(23％),p> 0．05。2组心率及血液生化检查结果,治疗前后变化均无显著意义(P>0．05),均无严重不良反应发生。结论:依普罗沙坦与氯沙坦均能有效降低轻、中度EH病人的血压,疗效相似,都具有良好的安全性。

Comparison of eprosartan and losartan in patients with mild to moderate essential hypertension

AIM:To evaluate the efficacy and safety of eprosartan and losartan in patients with mild to moderate essential hypertension. METHODS: In a double-blind, randomized controlled trial, 50 patients with sitting DBP≥90 mmHg (1 mmHg = 0.133 3 kPa) at the end of 2 wk placebo wash-out period were randomized into eprosartan group (n = 24) or losartan group (re = 26). The patients received eprosartan (600 mg, qd) or losartan (50 mg, qd) for 4 wk. Patients with an unsatisfactory blood pressure response (sitting DBP≥90 mmHg) were administrated with hydrochlorothiazide 12.5 mg until 8 wk. Blood pressure and heart rate were observed and laboratory parameters such as blood and urine routine, hepato-renal function, fasting blood glucose, lipid profile and serum electrolytes were tested at baseline and the end of treatment. RESULTS: The total effective rates were 100 % in eprosartan group and 81 % in losartan group, respectively. There was no significant difference between two groups (P > 0.05). At 8 wk, the reductions of SBP and DBP were (12±s 10) mmHg and (12±5) mmHg in eprosartan group and (14±9) mmHg and (10±6) mmHg in losartan group (P > 0.05). There were significant differences before and after treatment in both groups (P < 0.01), with no difference in reduction of blood pressure between two groups (P > 0.05). At 4 wk, 9 patients in eprosartan group and 6 ones in losartan group were administrated with hydrochlorothiazide. No significant changes were found in laboratory test and heart rate, and no severe adverse events were observed within 8wk in both groups. CONCLUSION: Eprosartan and losartan are both equally effective and safe in the treatment of patients with mild to moderate essential hypertension.