贝那普利与卡托普利降压效果的对比研究

目的 对比观察贝那普利与卡托普利治疗轻、中度高血压患者的临床疗效与安全性.方法 将120例高血压患者随机平分为两组,分别给予贝那普利和卡托普利治疗,均加用小剂量氢氯噻嗪, 治疗8周, 于治疗前及治疗8周末行血压监测, 评定各组降压效果.结果 贝那普利组患者降压有效率高于卡托普利组,组间比较差异有统计学意义(P<0.05);不良反应发生率两组间差异无统计学意义(P>0.05).结论 贝那普利对轻、中度原发性高血压病有较好的降压效果,联合应用小剂量利尿剂可提高疗效.     

贝那普利/氨氯地平复方制剂与贝那普利单药对高血压患者动态血压的影响

目的:应用动态血压监测(ABPM)技术评价贝那普利/氨氯地平复方制剂与贝那普利单剂对动态血压的影响.方法:本研究为随机、双盲、平行对照研究.经2周洗脱期,口服贝那普利10 mg单药治疗后,平均坐位舒张压(SeDBP)≥90 mmHg、且经ABPM检查平均舒张压≥82 mmHg的高血压患者,随机分为贝那普利(10 mg)/氨氯地平(5 mg)复方制剂组(qd)和贝那普利单剂组(20 mg·d-1).治疗4周末,两组诊室SeDBP≥90 mmHg者剂量加倍,SeDBP<90 mmHg者维持原剂量继续治疗4周.结果:治疗8周末,两组24 h、日间及夜间平均血压均较给药前明显下降.复方制剂组与贝那普利单剂组DBP/SBP的谷/峰比率(T/P)为83.12%/75.98%和85.83%/79.47%.结论:贝那普利/氨氯地平复方制剂每日1次口/服耐受性良好,并能24 h平稳降压.     

贝那普利治疗原发性高血压患者50例疗效观察

目的：探讨贝那普利治疗原发性高血压的疗效及不良反应。方法：对2007年3～11月收治的轻、中度原发性高血压病患者50例应用贝那普利10mg,1次/日口服治疗。结果：贝那普利治疗4周后患者血压降低有非常显著意义（P〈0.01）;单用贝那普利的患者有效率为90.0%,而合用利尿剂后总有效率为100.0%。结论：贝那普利对轻、中度原发性高血压病均有较好疗效,是一种长效、安全的降压药,而且对患者的肝肾功能、血脂、血糖及血电解质均无明显影响。     

贝那普利联合氢氯噻嗪对高血压患者左室重构逆转作用的观察

目的探讨贝那普利联合氢氯噻嗪对高血压患者左室重构逆转作用。方法纳入30例高血压合并左室肥厚的患者,运用贝那普利10mg联合氢氯噻嗪12.5mg治疗,观察4周、8周、12周血压情况及心脏形态学变化情况。结果贝那普利联合氢氯噻嗪治疗后自第四周开始舒张压和收缩压均呈现出下降趋势（P〈0.01）;自第四周开始左室舒张末径（LVDD）、左房前后径（LAD）、室间隔厚度（IVST）、左室后壁厚度（LVPWT）均呈现下降趋势（P〈0.01）,而左心室舒张末期容积（LVEDV）无显著变化。结论贝那普利联合氢氯噻嗪可良好的控制血压,并能逆转左室重构。     

国产复方非洛地平缓释片治疗原发性高血压的疗效和安全性

目的 评价国产复方非洛地平缓释片治疗轻、中度原发性高血压的疗效和安全性.方法 采用多中心、随机、双盲双模拟、前瞻性平行对照方法,从321例高血压患者中筛选出经非洛地平(5mg)单药治疗4wk、血压不能满意控制者217例,随机分为试验组和对照组,继续治疗8wk,分别服用复方非洛地平缓释片(由马来酸依那普利和缓释非洛地平组成,5mg/5mg)1片和非洛地平缓释片(5mg)、马来酸依那普利片(5mg)各1片.双盲治疗4wk后DBP不低于90mm Hg(1mm Hg=0.133kPa)者剂量加倍.结果 前4wk非洛地平单药治疗的有效率32.4%,降压无效而人组者血压平均下降(5.4±3.3/2.7±1.9)mm Hg.后8wk联合用药降压的总有效率试验组和对照组分别为88.3%和92.2%,血压分别进一步下降16.2/10.5mm Hg和14.8/11.4mm Hg.单药的不良反应主要为头痛、头晕、头胀、面部潮红等(12.0%).双盲试验期不良反应总发生率试验组和对照组分别为19.4%和14.7%,其中干咳发生率分别占6.5%和8.3%.结论 国产复方非洛地平缓释片治疗轻、中度原发性高血压安全、有效.     

贝那普利联合乐卡地平治疗轻、中度原发性高血压101例疗效观察

目的评价联用贝那普利与乐卡地平治疗轻、中度原发性高血压的疗效及安全性。方法将101例轻中度高血压患者随机分成2组:联用组(贝那普利10mg+乐卡地平10 mg)和单药组(贝那普利10 mg);服药4周后,舒张压≥90 mmHg的患者,贝那普利增加至20 mg并服用至8周;舒张压<90 mm Hg的患者,维持原剂量至8周,评价治疗14,8,周后的降压幅度、降压疗效及安全性。结果治疗1,4,8周后,2组的血压较治疗前均有下降;治疗1,4,8周后下降幅度,2组分别为(20.22±13.42)/(7.87±10.04)mmHg vs(17.46±15.88)/(7.17±7.71)mmHg(P>0.05);(23.00±15.12)/(11.65±8.73)mmHg vs(16.69±14.78)/(7.98±8.43)mmHg(P<0.05);(26.11±13.70)/(14.87±8.93)mm-Hg vs(17.81±12.35)/(7.19±8.96)mmHg(P<0.05);降压总有效率2组分别为67.4%vs 58.3%(P>0.05),87.0%vs 64.6%(P<0.05)和89.1%vs67.0...     

氯沙坦钾氢氯噻嗪与贝那普利对原发性高血压的疗效观察

目的以贝那普利进行临床对比研究观察,评价进口氯沙坦钾氢氯噻嗪片在高血压患者中的降压疗效和不良反应。方法随机化、双盲、平行活性药物对照研究。将44例原发性高血压患者分为两组（完成41例）。氯沙坦钾氢氯噻嗪片组20例,服用氯沙坦钾氢氯噻嗪片1片,用药5周。贝那普利片组21例,服用贝那普利10mg,用药5周。结果氯沙坦钾氢氯噻嗪片与贝那普利的降压有效率和降压幅度比较,差异无显著性（有效85％比81％）,P〉0．05,治疗前后同组间收缩压、舒张压下降幅度有显著性差异,两组用药前后心率变化无显著变化。结论氯沙坦钾氢氯噻嗪片治疗高血压患者疗效安全,使病人顺从性好。     

非洛地平治疗轻中度高血压30例

目的 :评价非洛地平治疗轻、中度高血压病的疗效和安全性 ,并与贝那普利比较。方法 :将 5 0例患者作随机单盲自身交叉对照试验 ,非洛地平组给药 5～ 10mg d ,贝那普利组给药 5～ 10mg d ,疗程 4周。结果 :两组偶测血压的降幅差异不显著 ,非洛地平组 2 4h平均血压和白天血压的降幅略大于贝那普利 ,且夜间血压的的降幅显著低于白天 ,而贝那普利则差异不显著。结论 :两药均能有效控制血压     

贝那普利与氨氯地平或吲哒帕胺联合治疗原发性高血压64例

目的比较贝那普利单用和其与氨氯地平或吲哒帕胺联用治疗轻、中度原发性高血压的疗效。方法64例轻、中度高血压患者,均单用贝那普利(一日1次10mg),4周后随机分为2组,分别与氨氯地平(一日1次5mg)或吲哒帕胺(一日1次2.5mg)联用4周。结果贝那普利单用4周后,患者坐位血压和24小时动态血压均下降(P<0.05或P<0.01),收缩压和舒张压的谷峰比(T/P)为0.82和0.86。与贝那普利单用相比,联用氨氯地平或吲哒帕胺4周,患者坐位血压降低的总有效率从49%增加为89%和91%;动态血压显示联合用药降压作用显著增强。结论贝那普利具有较强且持久的降压作用,与氨氯地平或吲哒帕胺联用可增强降压作用。     

比索洛尔/氢氯噻嗪复方片治疗原发性高血压的疗效与安全性

目的 评价比索洛尔/氢氯噻嗪复方片治疗轻中度原发性高血压的临床疗效与安全性。方法采用随机、双盲、平行对照的方法，选择轻中度原发性高血压患者 31 例，经2周安慰药洗脱后，随机分为试验组16例和对照组15 例。试验组给予比索洛尔/氢氯噻嗪复方片（2.5 mg/6.25 mg）口服，对照组给予比索洛尔片2.5 mg口服，均每天1次。治疗4周末若坐位舒张压仍≥90 mmHg（1 mmHg＝0.133 kPa），则剂量分别加至比索洛尔/氢氯噻嗪复方片5 mg/6.25 mg或比索洛尔片5 mg，qd，治疗至8周末。于安慰药洗脱末及治疗2，4，6，8周末测量诊室血压、心率、体征并记录不良反应。试验开始前及结束时进行实验室及心电图检查。结果共29例患者完成试验，其中试验组16例，对照组13例。两组服药后4周末和8周末坐位收缩压、舒张压及心率与服药前比较均明显降低(均P＜0.01)；试验组坐位舒张压下降幅度较对照组大(P＜0.05)；试验组8周末坐位收缩压下降幅度较对照组大(P＜0.05)。服药8 周后，试验组总有效率（93.75%）明显高于对照组（53.33%）（P＜0.05）。两组不良反应均较轻而少，组间比较差异无显著性。两组治疗前后实验室检查指标异常率差异无显著性。结论每天一次给予比索洛尔/氢氯噻嗪复方片2.5～5.0 mg/6.25 mg治疗轻、中度原发性高血压的疗效优于单药比索洛尔，且安全性好。     

缬沙坦/氢氯噻嗪复方制剂和缬沙坦降压疗效的比较

目的:对比缬沙坦/氢氯噻嗪(缬沙坦80mg/氢氯噻嗪12.5mg)复方制剂与缬沙坦(缬沙坦80mg)治疗轻、中度原发性高血压的谷峰比值(TPR)和平滑指数(SI),评价缬沙坦/氢氯噻嗪的降压疗效。方法:选择轻、中度原发性高血压病患者[SBP≥140mmHg且<160mmHg(1mmHg=0.133kPa),DBP≥95mmHg并且<110mmHg]84例,随机分为缬沙坦/氢氯噻嗪和缬沙坦组,共服药8周,观察服药前后血压及生化指标的变化。结果:治疗8周后,缬沙坦/氢氯噻嗪组和缬沙坦组降压有效率分别为84.2、52.5,达标率分别为73.9、42.9,两组间差异有统计学意义(P<0.001)。缬沙坦/氢氯噻嗪组TPR为SBP76.7、DBP71.2,均>50;SI为SBP1.14±0.39、DBP1.09±0.27,均>1。缬沙坦组的TPR为SBP77.6、DBP71.3,均>50;SI为SBP1.24±0.39、DBP1.19±0.27,均>1。两组的TPR和SI差别无统计学意义(P>0.05)。结论:缬沙坦80mg/氢氯噻嗪12.5mg复方制剂治疗轻中度原发性高血压患者疗效优于单用缬沙坦80mg,TPR和SI...     

厄贝沙坦与氢氯噻嗪联合治疗原发性高血压的疗效和安全性评价

目的 :观察厄贝沙坦(国产)与氢氯噻嗪治疗1、2级原发性高血压的疗效和安全性。方法 :73例1、2级原发性高血压患者随机分成两组 ,分别服用厄贝沙坦150mg日1次与氢氯噻嗪12 5mg日1次和卡托普利25mg日3次与氢氯噻嗪12 5mg日1次 ,治疗4周。观察用药前后血压、心率变化 ,记录患者用药的不良反应 ,结合实验室检查作安全性评价。结果 :两组治疗前后相比 ,血压下降差异有非常显著性(P<0 01)。厄贝沙坦组总有效率为80 6% ,卡托普利组为77 1% ,两组间比较差异无显著性(P>0 05) ,但药物相关不良反应前者显著低于后者(P<0 05)。结论 :厄贝沙坦与氢氯噻嗪联合应用治疗1、2级原发性高血压疗效确切 ,患者耐受性和安全性较好     

Candesartan cilexetil plus hydrochlorothiazide combination: a review of its use in hypertension

The combination of candesartan cilexetil [an angiotensin II type 1 (AT(1)) receptor antagonist] plus hydrochlorothiazide (a thiazide diuretic), has been used in the treatment of patients with hypertension. The blood pressure (BP) lowering effect of various doses of this combination, administered orally once a day for 4 to 52 weeks, has been demonstrated in clinical trials. These studies showed that combinations of candesartan cilexetil 4 to 16 mg with hydrochlorothiazide 12.5 or 25 mg induced significant reductions reductions in systolic (S) BP and diastolic (D) BP from baseline in patients with mild to severe hypertension. Data from clinical trials indicated that reductions in BP induced by candesartan cilexetil 4 to 32 mg/hydrochlorothiazide 12.5 mg combinations were significantly greater than those observed after monotherapy with either drug. Treatment for 8 weeks with candesartan cilexetil 16 mg/hydrochlorothiazide 12.5 mg or candesartan cilexetil 16 mg induced SBP/DBP reductions of 12.0/7.5 mm Hg and 7.5/5.5mm Hg, respectively (p < 0.05 both comparisons). Moreover, data from a randomised, double-blind, placebo-controlled, dose-finding study in 1038 patients with mild to moderate hypertension showed that the greatest reductions in SBP/DBP were achieved by candesartan cilexetil 16 mg/hydrochlorothiazide 12.5 mg. Significant differences in BP reduction in favour of the combination were observed when hypertensive patients were given candesartan cilexetil 4 or 8 mg/hydrochlorothiazide 12.5 mg or hydrochlorothiazide monotherapy for 8 weeks. Additionally, greater efficacy of the combination compared to monotherapy with either drug was demonstrated by response rates to treatment. Moreover, a fixed combination of candesartan cilexetil 16 mg/hydrochlorothiazide 12.5 mg demonstrated a greater antihypertensive effect than losartan 50 mg/hydrochlorothiazide 12.5 mg in two clinical trials. Candesartan cilexetil 8 mg/hydrochlorothiazide 12.5 mg showed a similar antihypertensive effect compared with that of combined lisinopril 10 mg/hydrochlorothiazide 12.5 mg. Candesartan cilexetil/hydrochlorothiazide combination was well tolerated in patients with hypertension. Combined data from placebo-controlled trials showed that most adverse events were uncommon and not serious. Patients receiving combination therapy exhibited, among other adverse events, headache (3.2 vs 5.5% for candesartan cilexetil/hydrochlorothiazide and placebo, respectively), back pain (3.0 vs 2.4%), dizziness (2.6 vs 1.2%) and respiratory infection (2.5 vs 1.4%). Moreover, 3.3 and 2.7% of patients receiving candesartan cilexetil/hydrochlorothiazide or placebo, respectively, discontinued treatment because of adverse events. CONCLUSION: The combination of candesartan cilexetil and hydrochlorothiazide (AT(1)-receptor antagonist and thiazide diuretic, respectively) is an effective treatment for patients with hypertension. Data from randomised, double-blind, placebo-controlled clinical trials showed that this combination is significantly more efficacious than either agent alone. Moreover, the combination of these two agents showed an excellent adverse event profile. Current data support the use of this combination as an alternative when monotherapy with either agent is not effective, and there are no compelling or specific indications for other drugs. However, data from large clinical trials, evaluating morbidity and mortality outcomes, are needed to determine the precise role of candesartan cilexetil/hydrochlorothiazide combination in the treatment of patients with hypertension.     

苯那普利与小剂量氢氯噻嗪合用治疗高血压疗效观察

目的：研究苯那普利与小剂量氢氯噻嗪合用对高血压患者的疗效。方法：采用随机分组法将60例原发性高血压病人分为两组,A组30例单用苯那普利10mg,每日一次;B组30例用苯那普利10mg,每日一次,加服氢氯噻嗪12．5mg,每日一次。两组治疗时间均为4周。观察治疗前后的基础血压及24h动态血压,并测定治疗前后的空腹血糖、血脂、血尿酸、尿素氮、肌酐。结果：苯那普利加小剂量氢氯噻嗪组的总有效率及24h动态血压的结果明显优于单用苯那普利组,两组治疗前后的代谢指标均无明显改变。结果：苯那普利与小剂氢氯噻嗪合作治疗高血压较单用苯那普利更有效,而且对代谢无明显影响。     

Treatment of mild and moderate hypertension with medroxalol, an alpha- and beta-adrenergic antagonist

Medroxalol, a new antihypertensive agent with alpha- and beta-adrenoreceptor blocking properties in both animals and humans, was administered in a single-blind study for 12 weeks to 29 patients with mild and moderate hypertension (standing blood pressure: 188-130/130-100 mm Hg). After 4 weeks of placebo administration, treatment with oral medroxalol was begun. Six weeks later, half the subjects added hydrochlorothiazide, 12.5 mg twice daily, to medroxalol for an additional 6 weeks, and the other half added placebo. During the final 4-week period medroxalol, but not hydrochlorothiazide, was discontinued and placebo substituted. Oral medroxalol doses of 100-400 mg twice daily reduced standing diastolic pressure to less than 100 mm Hg in 21 of the 26 subjects who completed the study. Compared to the last values on placebo, mean standing blood pressure was decreased by 15.6/12.0 mm Hg during the first 6 weeks of medroxalol at mean daily doses of 388-407 mg. Addition of hydrochlorothiazide permitted some decrease in medroxalol dosage. Upon medroxalol withdrawal, blood pressure and heart rate returned toward pretreatment values, with subjects continuing on diuretic showing lower blood pressures than the untreated individuals. Tolerance to medroxalol, with or without hydrochlorothiazide, was good. Mild orthostatic dizziness was the most frequent complaint associated with therapy, but postural hypotension was not found on physical examination. Medroxalol appears to be effective and well tolerated for reducing the blood pressure of most patients with mild to moderate hypertension and may be useful for chronic oral therapy of this disease.     

Once vs twice daily administration of a fixed combination of captopril plus hydrochlorothiazide in essential hypertension: a double-blind crossover study in known responders to a standard combination.

The purpose of this randomized, double-blind, crossover trial was to compare the hypotensive effects of a fixed combination of captopril (C) 50 mg and hydrochlorothiazide (HCTZ) 25 mg (C 50/HCTZ 25) once daily with those of a fixed combination of C 25 mg and HCTZ 12.5 mg (C 25/HCTZ 12.5) twice daily. We studied 199 patients (108 M, 91 F) with mild to moderate essential hypertension whose BP was already controlled by the co-administration of C 25 mg and HCTZ 12.5 mg twice daily. They were randomly assigned to either C 25/HCTZ 12.5 twice daily during the first 6 weeks and C 50/HCTZ 25 once daily during the second 6 weeks or C 50/HCTZ 25 once daily followed by C 25/HCTZ 12.5 twice daily. Both regimens showed comparable efficacy on office diastolic BP (91.6 vs 91.3 mm Hg). Systolic BP was slightly but significantly higher (P = 0.02) with the once daily formulation (141.2 vs 139.1 mm Hg). Fixed combinations once daily and twice daily resulted in identical working ambulatory BP (133.7 +/- 13/83.6 +/- 8 mm Hg vs 132.4 +/- 11/83.3 +/- 7 mm Hg) without affecting heart rate. Adverse events were reported by 16% of patients and cough was the most common occurring in 7%. In conclusion, these results indicate that the fixed combination of C 50/HCTZ 25 given once daily controls office and working BP as well as the fixed combination C 25/HCTZ 12.5 given twice daily in patients with mild to moderate hypertension.     

Efficacy and Safety of Olmesartan Medoxomil and Hydrochlorothiazide Compared with Benazepril and Amlodipine Besylate

BACKGROUND: Most patients with stage 2 hypertension require two or more antihypertensive agents in order to achieve the BP goals recommended in current treatment guidelines. Accordingly, combinations of two drugs with different mechanisms of antihypertensive action are widely used. OBJECTIVE: The aim of this randomized, double-blind, multicenter 12-week study was to compare the efficacy, safety, and tolerability of a combination of olmesartan medoxomil/hydrochlorothiazide (HCTZ) with that of benazepril plus amlodipine besylate in patients with stage 2 hypertension. METHODS: Patients were eligible for randomization following a 3- to 4-week placebo run-in period if they had either (i) mean seated DBP>or=90 mm Hg but<115 mm Hg and mean seated SBP>or=160 mm Hg but <200 mm Hg, or (ii) mean seated DBP>or=100 mm Hg but<115 mm Hg. The difference in mean seated SBP measured on two separate visits during the run-in period was required to beor=95 mm Hg and<115 mm Hg or SBP>145 mm Hg and相似文献   

Long-term antihypertensive effects and safety of nitrendipine in patients with mild, moderate, and severe hypertension

A study of 31 patients with mild or moderate hypertension and 17 patients with severe hypertension was conducted to evaluate the long-term safety and efficacy of nitrendipine, a new calcium channel blocker with a long duration of action. Nitrendipine (5-40 mg bid) was given as monotherapy or in combination with hydrochlorothiazide and/or propranolol. Seventeen patients (54%) with mild to moderate hypertension were controlled with nitrendipine alone, but all except one patient with severe hypertension required combination therapy. In patients with mild or moderate hypertension, nitrendipine reduced supine blood pressure from a baseline mean 154/100 mm Hg to 136/87 mm Hg after 1 year of treatment (P less than .05). In patients with severe hypertension, supine blood pressure was reduced from 186/124 mm Hg to 148/91 mm Hg by the end of the planned treatment period (P less than .05; mean duration, 10 weeks). During extended observation, antihypertensive effect was sustained for up to 2.5 years and 1.6 years in patients with mild or moderate and severe hypertension, respectively. Nitrendipine was well tolerated; and only one patient, a moderate hypertensive, discontinued treatment because of pedal edema. The results of this long-term study show that nitrendipine alone or in combination with a diuretic and/or a beta blocker is a safe and effective agent for the treatment of patients with all degrees of hypertension.     

A comparison of fosinopril and hydrochlorothiazide with hydrochlorothiazide in non-insulin-dependent diabetes mellitus patients with mild to moderate hypertension

A multicentre, randomised, double-blind, parallel-group study of the tolerability and antihypertensive efficacy of once-daily fosinopril 20 mg/hydrochlorothiazide 12.5mg (FOS/HCTZ) compared with once-daily hydrochlorothiazide 25mg (HCTZ) was conducted in 142 patients with non-insulin-dependent diabetes mellitus (NIDDM) and mild to moderate essential hypertension. After 12 weeks of treatment, both groups had statistically significant mean changes from baseline in seated diastolic and systolic blood pressures (FOS/HCTZ, -15.0mm Hg; HCTZ, -11.9mm Hg for seated diastolic blood pressure). The difference between treatment groups was statistically significant (p < 0.001). In addition, normalisation of seated diastolic blood pressure was achieved in 85% of FOS/HCTZ patients compared with 71% of HCTZ patients. A statistically significant difference (p < 0.05) in favour of FOS/HCTZ was observed for the total number of favourable responses (normalisation or >/=10mm Hg reduction in seated diastolic blood pressure) at week 12 and for the end-point analysis. One FOS/HCTZ patient and 5 HCTZ patients discontinued treatment because of adverse events. No clinically significant changes in serum glucose, potassium or cholesterol were observed. A slight but statistically significant increase in fasting triglycerides occurred with FOS/HCTZ compared with HCTZ (+26.1 vs +13.5 mg/dl, respectively; p < 0.05). These results show that the combination of fosinopril and hydrochlorothiazide has considerable potential as an effective antihypertensive regimen that does not significantly alter glucose or lipid metabolism in patients with NIDDM.