氯沙坦治疗轻、中度高血压病疗效的评价

目的 :评价氯沙坦治疗轻、中度高血压病患者的疗效。方法 :采用随机双盲试验 ,将轻、中度高血压病 （EH）患者随机分为氯沙坦组 （36例 ）和依那普利组 （34例 ） ,分别服用氯沙坦 5 0 m g/d和依那普利 10 m g/d,共 8周。治疗 4周后 ,对舒张压 （DBP）≥ 90 m m Hg的患者 ,剂量加倍。于服安慰剂期末和治疗 4,8周末观察 DBP和收缩压 （SBP）及心率 （HR）、干咳发生率及临床实验室检查。结果 :8周末 ,氯沙坦组有效率为 72 % ,依那普利组为 74% ,两组间无显著差异 （P>0 .0 5 ）。两组平均 DBP和 SBP均有显著下降 ,两组间血压降幅无显著差异 （P>0 .0 5 ）。干咳发生率氯沙坦组 （3% ）明显低于依那普利组 （18% ,P<0 .0 1）。结论 :氯沙坦 5 0～ 10 0 m g/d治疗轻、中度高血压病疗效确切 ,干咳发生率低。     

氯沙坦与依那普利治疗轻中、度高血压病的疗效比较

目的：比较氯沙坦与依那普利治疗轻中,度高血压病的疗效和安全性,方法：采用随机,开放,对照试验,87例轻,中度高血压患被分为氯沙坦组（54例）,依那普利组（45例）,治疗8周。结果：两组药物均能明显降低血压（P＜0．01）,但有效率,降压幅度值无显差异,氯沙坦组的降压谷峰比值较依那普利组的高,氯沙坦组无明显不良反应,依那普利组2例发生咳嗽,因而退出试验。结论：对于轻,中度高血压病,氯沙坦是一种有效,安全 ,易耐受的降压药,每日50－100mg能维持24小时的降压效应。     

缬沙坦治疗轻、中度高血压病的疗效和安全性

目的 :评价缬沙坦 （Valsartan,VAL ）治疗轻、中度高血压病的疗效和安全性。方法 :采用随机、单盲和平行对照方法 ,经 1周药物冲洗期及 2周安慰剂导入期后 ,10 2例轻、中度高血压患者进入 8周治疗期 ,每日 1次服用 VAL80 m g（5 2例 ）或依那普利 （Enalapril,ENA ） 5 m g（5 0例 ） ,2周后如坐位舒张压 （Si DBP）≥ 90 mm Hg（1m m Hg=0 .133k Pa）则剂量加倍 ,4周后如仍无效则每日加服双氢克尿噻 2 5 mg。于服安慰剂期末及治疗 2、4、6、8周末测诊室血压 ,心率 （HR）并记录症状、体征 ;于服安慰剂末及治疗 8周末行 2 4 h动态血压监测 （ABPM）各 1次。结果 :两组药物均能明显降低血压 （P<0 .0 1） ;VAL组有效率 92 % ,ENA组有效率 88% ,组间比较无显著性差异 （P >0 .0 5 ）。 8周末 VAL组 Si SBP/ Si DBP下降 （2 1± 9） / （16± 5 ） mm Hg,ENA组下降 （2 0± 9） / （13± 7） mm Hg。 2、4、6、8周末血压下降值 ,组间比较无显著性差异 （P>0 .0 5 ）。 VAL组和 ENA组分别有 4 4 %和 6 0 %患者加用利尿剂。VAL降压谷峰值比率 6 9% ,ENA为 4 9%。咳嗽发生率 VAL组 （4% ）明显低于 ENA组 （18% ） ,差异有显著性 （P<0 .0 5 ）。结论 :VAL （80～ 16 0 m g/ d）对轻、中度高血压病疗效确切、安全、耐受性好 ,干咳的不良反应明显低于     

氯沙坦治疗高血压病前后血管内皮功能的变化——与血管紧张素Ⅱ和内皮素对比

目的　研究氯沙坦治疗高血压病前后血管内皮功能和血浆血管紧张素Ⅱ和内皮素的变化。方法　 5 0例高血压病患者氯沙坦治疗 4～ 6周前后根据所达目标血压(根据舒张压 <90mmHg调整降压药每天剂量 5 0mg到 10 0mg ,部分加噻嗪类利尿剂 2 5mg) ,观察氯沙坦治疗前后肱动脉超声检测血管内皮功能和血浆血管紧张素Ⅱ和内皮素浓度的变化。结果　肱动脉内径基础值及含服硝酸甘油前后肱动脉内径变化均无显著性差异 (3 78± 0 5 7对 3 82± 0 6 3,18 7± 4 5对 2 0 1± 7 2 ,P >0 0 1) ,反应性血管充血引起肱动脉内径的变化治疗前后有显著性差异 (4 32± 0 71、9 38±4 1、P <0 0 1)。氯沙坦治疗前后血浆血管紧张素Ⅱ浓度变化显著 (38.6± 6 .8对 76 9± 15 3 ,P <0 0 1)。氯沙坦治疗前后血浆内皮素浓度变化显著 (10 3 12± 2 4 5 9对 73 81±18 2 6 ,P <0 0 1)。结论　氯沙坦在有效降压的同时 ,能有效改善血管内皮舒张功能。肱动脉超声用于观察降压药物对血管内皮功能的变化具有无创、简便、重复性高的特点。     

不同时期氯沙坦短暂治疗对自发性高血压大鼠心脏AT1受体、AT2受体表达的影响

目的 观察不同时期氯沙坦短暂治疗对自发性高血压大鼠(SHR)的血压变化及心脏AT1受体、AT2受体表达的影响,探讨血管紧张素Ⅱ 1型受体(AT1R)、血管紧张素Ⅱ2型受体(AT2R)在高血压发病机制中的作用,为早预防、早治疗高血压开辟新的途径.方法 选用4周龄SHR及京都Wistar大鼠(WKY),分成4组:氯沙坦4周...     

伊贝沙坦治疗原发性高血压疗效观察

2001～2002年,我们采用伊贝沙坦治疗原发性高血压43例,疗效满意。现报告如下。 临床资料:本文轻、中度原发性高血压患者(舒张压90～109mmHg,收缩压140～179mmHg)43例,男33例,女10例;年龄43～68岁,平均(52.23±9.41)岁。均排除继发性高血压     

钙离子拮抗剂和血管紧张素Ⅱ受体阻断剂对高血压患者动脉僵硬度影响的Meta分析

目的 系统评价钙离子拮抗剂(CCB)和血管紧张素Ⅱ受体阻断剂(ARB)对高血压患者血管功能的作用差异.方法 按循证医学的要求,制定相应的纳入、排除标准及其检索策略.通过PubMed、Embase、Ovid EMBReviews、中国期刊全文数据库、中文科技期刊全文数据库、万方数据库检索相关的临床对照研究,检索各数据库从建库至2012年1月;纳入CCB和ARB治疗原发性高血压的随机对照试验.采用RevMan5.0软件进行统计分析.比较CCB和ARB对高血压患者脉搏波传导速度、收缩压、舒张压、脉压等指标的影响.结果 共纳入6个随机对照试验,共计411例患者.Meta分析结果显示,ARB在改善动脉僵硬度方面优于CCB(均数差为183.33,95％ CI为79.32 ～ 287.33),差异有统计学意义.但是在降低收缩压(均数差为-2.66,95％ CI为-3.35 ～-1.96)和舒张压(均数差为-5.43,95％ CI为-8.8 ～-2.07)方面较CCB弱.结论 ARB在改善高血压患者动脉僵硬度方面优于CCB,该作用与其降压作用无关.但仍需要大样本多中心的随机对照临床试验来进一步证实.     

氯沙坦治疗充血性心力衰竭38例疗效观察

氯沙坦为血管紧张素Ⅱ受体(AT1型)拮抗剂,在治疗心力衰竭方面疗效明显.我院在1999年12月至2003年12月间对38例充血性心血衰竭患者在常规治疗的基础上加用氯沙坦片,取得较满意疗效,现报告如下:     

氯沙坦、苯那普利及二者联合治疗高血压病的对比性研究

目的对比氯沙坦、苯那普利及二者联合治疗轻、中度原发性高血压(EH)的降压效果及耐受性.方法入选的轻、中度EH患者(坐位舒张压90～109 mmHg)经1周药物冲洗期及2周安慰剂期后,随机分为3组(1)L组,口服氯沙坦 50 mg/天;(2)B组,口服苯那普利 10 mg/天;(3)L+B组,口服氯沙坦 50 mg/天,苯那普利 10 mg/天.疗程8周.共入选病例67例,完成8周观察者63例,L组22例,B组20例,L+B组21例.于服安慰剂期末及治疗1、2、4、6、8周末测诊室血压、心率(HR)并记录不良反应.治疗前后测血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)浓度.结果治疗8周后三组血压均下降,其中L组下降10.8±6.2/17.5±5.5 mmHg,总有效率59.1%;B组下降11.2±5.4/16.4±4.6 mmHg,总有效率65.0%;L+B组下降26.4±5.7/32.1±11.0 mmHg,总有效率95.2%.L+B组降压幅度最大,与L组、B组比较有统计学意义(P＜0.001).L组与B组的降压幅度及有效率无显著差异(P＞0.05).三组血浆ALD浓度在治疗后均下降,其中L+B组ALD下降较L组与B组显著(P＜0.001).氯沙坦组不良反应少.结论氯沙坦有明显降压作用,与苯那普利合用有叠加效应.     

氯沙坦对高血压病者心率变异性的影响

目的 探讨血管紧张素Ⅱ受体拮抗剂-氯沙坦对高血压病（EH）心率变异性（HRV）的影响。方法 对50例健康查体（A组）及90例EH口服氯沙坦治疗前后行24hDCG检查,分析心率功率谱时域和频域指标。结果 B组用药前后相邻正常RR间期标准差（SDNN）,RR间期平均值的标准差（SDANN）,高频功能和总功率,低频功率,低频功率/高频功率值分别显低于和高于A组,且治疗前后上述指标亦呈显变化。显示植物神经功能损害与病情呈正相关,治疗后血压有效下降的同时,HRV损害均有改善。结论 氯沙坦在降压的同时,可改善HRV。     

氯沙坦治疗原发性高血压的疗效和对尿清蛋白的影响

目的 探讨氯沙坦治疗轻、中度原发性高血压的疗效和对尿清蛋白的影响。方法 82例高血压患者随机分两组,氯沙坦组(治疗组,43例)50～100mg·d-1口服,疗程12周;培哚普利组(对照组,39例)4～8mg·d-1服,疗程12周。治疗前后做动态血压及肝、肾功能、血脂、血糖等检查,测定尿液中清蛋白(Alb),血清肌酐(Scr)及血尿素氮(BUN)的变化。结果 治疗组降压总有效率75％(33例),降压幅度(以mmHg计)收缩压(SBP)为21.舒张压(DBP)为13,谷/峰(T/P)比值SBP为0.73,DBP为0.71。对照组总有效率74％(29例),降压幅度SBP为22,DBP为12,谷/峰比值SBP为O.71,DBP为O.72,两组结果相似。治疗后两组尿Alb减低(P<0.01)。氯沙坦不良反应轻微。结论 氯沙坦对高血压有确切疗效,干咳发生率低,减少尿清蛋白的排泄,对肾脏有保护作用。     

Efficacy and safety of fixed-dose losartan/hydrochlorothiazide/amlodipine combination versus losartan/hydrochlorothiazide combination in Japanese patients with essential hypertension

Abstract

Japanese patients with uncontrolled essential hypertension received single-blind losartan 50?mg/hydrochlorothiazide 12.5?mg (L50/H12.5) for 8 weeks. Patients whose blood pressure (BP) remained uncontrolled were randomized double-blind to fixed-dose losartan 50?mg/hydrochlorothiazide 12.5?mg/amlodipine 5?mg (L50/H12.5/A5) or L50/H12.5 for 8 weeks followed by open-label L50/H12.5/A5 for 44 weeks. Adverse events were assessed. After 8 weeks, diastolic and systolic BP were reduced significantly more with L50/H12.5/A5 versus L50/H12.5 (both p?<?0.001). Mean changes in diastolic and systolic BP were sustained for 44 weeks. L50/H12.5/A5 was well-tolerated and improved BP significantly versus L50/H12.5 in Japanese patients with uncontrolled essential hypertension.

Trial registration: ClinicalTrials.gov identifier: NCT01299376.     

奥美沙坦酯与氯沙坦钾治疗中国轻、中度原发性高血压患者8周的疗效与安全性比较

目的 通过与氯沙坦钾比较评价奥美沙坦酯治疗轻、中度原发性高血压患者的疗效和安全性。方法采用随机、双盲、双模拟、阳性对照、平行分组、多中心临床试验方法。共入选287例轻、中度原发性高血压患者,按照1：1的比例随机分组,分别接受奥美沙坦酯20mg或氯沙坦钾50mg,每天1次口服治疗。在用药4周后对患者进行血压评价,如果患者舒张压（DBP）仍≥90mmHg（1mmHg=0．133kPa）,则试验药物剂量加倍,直至8周试验结束;治疗4周后DBP〈90mmHg的患者则维持原剂量继续治疗至第8周。结果（1）治疗4周后,奥美沙坦酯组坐位DBP谷值平均下降11．72mmHg,氯沙坦钾组平均下降9．23mmHg,两组间比较P=0．004。（2）治疗8周后,奥美沙坦酯组坐位DBP谷值平均下降12．94mmHg,氯沙坦钾组平均下降11．01mmHg,两组间比较P=0．035。（3）治疗4周后,奥美沙坦酯组有效数为81例（65．3％）,氯沙坦钾组有效数为68例（52．7％）,两组间比较P=0．028;治疗8周后,两组有效病例数和有效率相当,P〉0．05。（4）治疗8周后,24h动态血压监测显示,奥美沙坦酯组DBP和SBP的个体和总体谷／峰比值均高于氯沙坦钾组,奥美沙坦酯在24h内的作用持续时间比氯沙坦钾组长。（5）奥美沙坦酯组和氯沙坦钾组发生的与试验药物有关的不良事件的发生率分别为10．5％和13．9％,P〉0．05。结论奥美沙坦酯每日口服20～40mg能够有效、安全地治疗高血压。与氯沙坦钾每日口服50-100mg相比,奥美沙坦酯的降压效果优于氯沙坦钾。     

Efficacy and safety of losartan/hydrochlorothiazide in patients with severe hypertension

This 12-week, open-label, multicenter study assessed the efficacy and safety of losartan/hydrochlorothiazide (HCTZ), alone or in combination with other antihypertensive agents, in the treatment of patients with severe systemic hypertension. Treatment began with once-daily losartan/HCTZ 50/12.5 mg. The dose was increased to 100/25 mg, if required, to achieve blood pressure (BP) control (sitting diastolic BP <95 mm Hg); felodipine (extended release) and/or atenolol could be added if target sitting diastolic BP was not achieved with losartan/HCTZ alone. Mean sitting systolic BP of the 131 patients enrolled was 165.3 mm Hg at baseline and 139.8 mm Hg at final visit (reduction -25.4 mm Hg; p < or =0.01). Mean sitting diastolic BP was 111.9 mm Hg at baseline and 93.6 mm Hg at final visit (reduction -18.4 mm Hg; p < or =0.01). After 2 weeks of treatment, 63.8% of patients (83 of 130) were taking losartan/HCTZ 50/12.5 mg alone. By the final visit, one third of patients (35.1%; 46/131) were still only taking losartan/HCTZ. Most patients (48.1%; 63 of 131) were taking losartan/HCTZ 100/25 mg plus felodipine (extended release) at the final visit. Losartan/HCTZ was well tolerated. Drug-related adverse experiences occurred in 30 patients (22.9%). Only 2 patients (1.5%) had a serious adverse experience; 6 patients (4.6%) discontinued the drug because of an adverse experience. In conclusion, losartan/ HCTZ, alone or as part of a regimen with other standard antihypertensive agents, is effective and well tolerated in the treatment of patients with severe hypertension.     

Efficacy and safety of combination therapy with losartan and hydrochlorothiazide in elderly hypertension

We examined the effect and safety of combination therapy with low-dose diuretics (hydrochlorothiazide: HCTZ) and angiotensin II receptor antagonist (losartan) in elderly cases of hypertension, using ambulatory blood pressure monitoring (ABPM). Elderly hypertensive patients (mean age 75 +/- 2 years) were treated with either losartan (25-50 mg/day) or HCTZ (12.5 mg/day) for at least 4 weeks, and then 24-hour blood pressure (BP) was measured by ABPM. Combination therapy with addition of other drug was initiated in 14 patients whose 24-hour systolic BP or daytime systolic BP was over 140 mmHg (160 mmHg for the patients of 80 years or older). After 4 weeks of the combination therapy, ABPM was repeated. Blood cell count and blood chemistry were also done before and after initiation of combination therapy. In the losartan-preceding group (n = 9), the combination therapy with HCTZ reduced 24-hour BP by 19.3 +/- 2.3/6.6 +/- 2.3 mmHg. Similarly, daytime and nighttime BP decreased by 21.4 +/- 4/8.4 +/- 2.8 mmHg and 15.2 +/- 4/4.2 +/- 2.4 mmHg, respectively. In the HCTZ-preceding group, the combination with losartan also decreased 24-hour BP by 12.2 +/- 4.8/3.4 +/- 1.4 mmHg. The decreases of daytime and nighttime BP were 13.8 +/- 6.6/4 +/- 1.1 mmHg and 10 +/- 4.7/3 +/- 2.4 mmHg, respectively. Heart rate did not change with combination therapy in the losartan-preceding group, while heart rate during daytime tended to decrease by addition of losartan in the HCTZ-preceding group (3.8 +/- 1.7/min). Serum electrolytes, uric acid, lipids, renal function and body weight did not change during the study period. Thus, combination therapy of losartan/hydrochlorothiazide seems useful in the treatment of elderly hypertension, showing additive BP lowering effect without metabolic adverse effects.     

Efficacy and safety of topiramate in the treatment of obese subjects with essential hypertension

The effect of topiramate on weight and blood pressure (BP) was examined in a randomized, placebo-controlled trial in obese subjects who had hypertension. After a 4-week, placebo, run-in period, 531 obese subjects (body mass index 27 to 50 kg/m(2)) who had established hypertension were randomly assigned to placebo or 96 or 192 mg/day of topiramate. All subjects received a standardized diet, exercise advice, and behavioral modification from run-in through study end. Initially scheduled for 60 weeks on medication, the sponsor ended the study early to develop a new controlled-release formulation. As a consequence, efficacy was assessed within a predefined modified intent-to-treat population (subjects who enrolled early enough to potentially complete 28 weeks on medication). The placebo and 96- and 192-mg groups had respective weight losses of 1.9%, 5.9%, and 6.5% from baseline (p <0.001 for each comparison with placebo) and decreases in diastolic BP of 2.1, 5.5, and 6.3 mm Hg (p <0.015 vs placebo). Systolic BP was decreased by 8.6 and 9.7 mm Hg in the 96- and 192-mg groups and 4.9 mm Hg in the placebo group (p = NS). Compared with placebo, the topiramate groups had larger proportions of subjects whose weight decreased by > or =5% and 10%, whose diastolic BP decreased by > or =5 and 10 mm Hg, and who achieved normalization of BP (BP <130/85 mm Hg). Adverse events included paresthesia, fatigue, taste perversion, loss of appetite, and difficulty with concentration and attention. In conclusion, topiramate produced clinically relevant effects in reducing body weight and BP, with generally mild to moderate adverse effects.     

海捷亚对轻中度原发性高血压的疗效和安全性的研究

目的:评价海捷亚的降压疗效及安全性。方法:27例轻中度原发性高血压患者,每日口服海捷亚1～2片,观察降压疗效及对实验室检查的影响。结果:降压的总有效率为66.6％。服药1周血压即明显下降,SBP/DBP由治疗前的(149.9±16.8/103.2±5.6)mmHg降至(138.6±13.3/93.3±6.9)mmHg,8周后降至(129.2±12.6/87.4±7.8)mmHg,心率无明显改变。不良反应轻微,总发生率10.0％。结论:海捷亚每日1次口服,降压起效快、作用平稳,不良反应少,服药方便,是较为理想的抗高血压药物。     

海捷亚对轻中度原发性高血压的疗效和安全性的研究

目的评价海捷亚的降压疗效及安全性.方法27例轻中度原发性高血压患者,每日口服海捷亚1～2片,观察降压疗效及对实验室检查的影响. 结果降压的总有效率为66.6%.服药1周血压即明显下降,SBP/DBP由治疗前的(149.9±16.8/103.2±5.6)mmHg降至(138.6±13.3/93.3±6.9)mmHg,8周后降至(129.2±12.6/87.4±7.8)mmHg,心率无明显改变.不良反应轻微,总发生率10.0%. 结论海捷亚每日1次口服,降压起效快、作用平稳,不良反应少,服药方便,是较为理想的抗高血压药物.