氯沙坦与氨氯地平的降压疗效及对左室肥厚逆转作用的比较

目的 :评价并比较氯沙坦及氨氯地平的降压疗效及对左室肥厚的逆转作用。方法 :12 0例高血压病伴左室肥厚病人随机分为 2组。氯沙坦组6 0例 ,给氯沙坦 2 5～ 50mg ,po ,qm。氨氯地平组6 0例 ,给氨氯地平 5～ 10mg ,po ,qm ;疗程均为 2 4wk。结果 :治疗 2 4wk后 ,氯沙坦组SBP和DBP下降差值分别为 (3.4± 1.7)kPa和 (2 .7± 0 .7)kPa ,氨氯地平组为 (3.2± 1.5)kPa和 (2 .2± 0 .9)kPa(均P<0 .0 1)。组间比较 ,氯沙坦组除偶测血压SBP外 ,DBP和 2 4h动态血压均较氨氯地平组下降显著 (P<0 .0 1)。2组室间隔厚度、左心室后壁厚度、左室心肌重量指数较治疗前显著改善 (P <0 .0 1)。结论 :氯沙坦与氨氯地平均能显著降压 ,并使左室肥厚逆转

Comparison of losartan and amlodipine for anti-hypertension and amelioration of left ventricular hypertrophy

AIM: To evaluate and compare losartan and amlodipine on the hypotensive effect and reverse reduction of left ventricular hypertrophy. METHODS: One hundred and twenty hypertensive patients with left ventricular hypertrophy were randomly divided into two groups: losartan group of 60 patients was treated with losartan 25-50 mg, po , qm for 24 wk and amlodipine group of 60 patients was treated with amlodipine 5-10 mg , po , qm for 24 wk. Twenty-four hours ambulatory blood pressure monitoring and color Doppler echocardiography were performed before and after treatment. RESULTS: After treatment of 24 wk, in losartan group SBP, DBP were reduced (3.4±1.5) kPa and (2.7±0.7)kPa; in amlodipine group SBP,DBP were reduced (3.2±1.5) kPa and (2.0±0.9) kPa, there were significant difference by t test ( P <0.01), SBP had no obvious differences ( P >0.05) and DBP were significantly decreased ( P <0.01) in the two groups. After 24 wk treatment with both drugs interventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass and index of left ventricular mass were improved significantly ( P < 0.01). CONCLUSION: Losartan and amlodipine can significantly reduce the blood pressure level and have reverse reduction of left ventricular hypertrophy in hypertensive patients with left ventricular hypertrophy. The therapeutic effect of losartan is similar to that of amlodipine.