尼贝沙坦联合氢氯噻嗪片治疗原发性高血压的疗效观察

【目的】观察尼贝沙坦联合氢氯噻嗪治疗原发性高血压临床疗效。【方法】本院门诊收治的高血压患者80例,随机分为尼贝沙坦联合氢氯噻嗪（治疗组）40例,单用尼贝沙坦组（对照组）40例。疗程均为8周,观察其对血压、血糖、血尿酸及电解质的影响。【结果】治疗组在治愈率和降压效果等方面明显优于对照组。【结论】尼贝沙坦联合氯噻嗪治疗原发性高血压安全有效,不良反应少。     

国产厄贝沙坦氢氯噻嗪治疗轻中度原发性高血压临床观察

目的:观察国产厄贝沙坦氢氯噻嗪片(依伦平)治疗轻中度原发性高血压的疗效及安全性.方法:将70例轻中度原发性高血压患者随机分为治疗组和对照组,每组35例.治疗组患者每天口服国产厄贝沙坦氢氯噻嗪片(含厄贝沙坦150 mg,氢氯噻嗪12.5 mg)1片,1次/d;对照组患者每天口服厄贝沙坦片(150 mg)1片,1次/d.治疗8周.观察两组治疗前后血压及生化指标.结果:国产厄贝沙坦氢氯噻嗪片治疗组降压疗效及降压效果均明显优于单药对照组,两组治疗前后血液生化指标与治疗前相比均无明显变化.治疗组不良反应发生率5.7%.结论:在轻中度原发性高血压患者中应用国产厄贝沙坦氢氯噻嗪片(依伦平)明显优于单药治疗,降压疗效满意,耐受性好,达标率高,有利于长期治疗.     

长期小剂量氢氯噻嗪治疗单纯收缩期高血压的疗效

目的观察单纯收缩期原发性高血压患者长期服用小剂量氢氯噻嗪的降压疗效。方法100例轻、中度单纯收缩期原发性高血压患者服用氢氯噻嗪12．5mg,每131次,每月发放一次药物并测量血压,观察1年。比较服药8周及1年降压疗效的变化及生化指标的变化。结果100例患者治疗1年时血压下降值高于8周时血压下降值,差异有统计学意义（P〈0．05）;治疗8周时的降压达标率为20．3％,治疗1年时的降压达标率为35．1％,差异有统计学意义（P〈0．05）;未发生低钾血症,但血尿酸值明显增加,与基线值比较差异有统计学意义（P〈0．05）。结论长期服用小剂量氢氯噻嗪可有效降低轻、中度单纯收缩期原发性高血压患者的血压,对电解质、血糖、血脂代谢无明显不良影响。     

缬沙坦联合小剂量氢氯噻嗪治疗原发性高血压的疗效

目的 探讨缬沙坦联合小剂量氢氯噻嗪治疗原发性高血压的效果.方法 将72例原发性高血压患者按随机数字表法分为对照组和治疗组各36例,对照组采用缬沙坦80 mg口服,每日1次,晨起空服.治疗组在此基础上加用氢氯噻嗪12.5 mg口服,每日1次.疗程8周.观察2组降压效果及不良反应发生情况.结果 疗程结束后治疗组的降压效果明显优于对照组,2组总有效率相比差异有统计学意义(94.44% vs 80.56%,P<0.05).2组患者治疗期间,均无严重不良反应.结论 缬沙坦联合小剂量氢氯噻嗪治疗原发性高血压效果明显优于单用缬沙坦,且不良反应广.     

氯沙坦合用氢氯噻嗪治疗老年高血压的临床研究

目的探讨氯沙坦合用氢氯噻嗪治疗老年高血压的疗效及其副作用。方法对68例老年高血压患者应用氯沙坦(科素亚)50 mg每日1次;同时合用氢氯噻嗪(双氢克尿塞)12.5 mg,每日1次,均晨顿服,2周后降压疗效不满意,氯沙坦加至100 mg,每日1次,疗程共12周。观察治疗前后随测血压、血糖、血脂、血钾、血尿酸和肝肾功能。结果氯沙坦合用氢氯噻嗪降压总有效率达89.7%,疗效显著,无明显副作用。结论氯沙坦合用氢氯噻嗪治疗老年高血压安全、有效。     

依那普利联合氢氯噻嗪治疗老年单纯收缩期高血压疗效观察

目的：观察依那普利联合小剂量氢氯噻嗪治疗老年单纯收缩期高血压的临床疗效。方法：150例老年单纯收缩期高血压患者,随机分为依那普利组（A组）、氢氯噻嗪组（B组）、依那普利加氢氯噻嗪组（C组）。每组50例,疗程6周,比较三组降压疗效,数据分析采用t检验和Χ^2检验。结果：依那普利加氢氯噻嗪组降压有效率90．0％,依那普利组降压有效率70．0％,氢氯噻嗪组降压有效率62．0％（P〈0．05）。结论：依那普利联合氢氯噻嗪治疗老年单纯收缩期高血压。疗效优于单用依那普利或氢氯噻嗪。依那普利联合小剂量氢氯噻嗪具有良好的协同降低收缩压的效果,副作用小,安全有效。     

替米沙坦、氢氯噻嗪、左旋氨氯地平小剂量联合治疗老年非杓型高血压的临床分析

目的:分析替米沙坦、氢氯噻嗪、左旋氨氯地平小剂量联合治疗老年非杓型高血压的临床疗效。方法:选取我院2016年1月~2017年4月收治的老年非杓型高血压患者74例,随机分为对照组和观察组各37例。对照组给予替米沙坦联合氢氯噻嗪治疗,观察组给予替米沙坦、、氢氯噻嗪、左旋氨氯地平小剂量联合治疗,比较两组治疗效果。结果:观察组治疗总有效率、血压昼夜节律达标率、动态血压达标率明显高于对照组,治疗后收缩压、舒张压、不良反应发生率均明显低于对照组(P0.05)。结论:替米沙坦、氢氯噻嗪、左旋氨氯地平小剂量联合方案可有效调节老年非杓型高血压的血压水平,治疗效果显著,用药安全性高,值得临床推广应用。     

长期小剂量利尿剂治疗慢性收缩性心力衰竭的疗效和安全性观察

目的观察长期口服小剂量利尿剂治疗慢性收缩性心力衰竭的疗效和安全性。方法将61例慢性收缩性心力衰竭患者随机分为A（n=31）、B（n=30）2组。在给予ACEI、β受体拮抗剂等治疗的同时,A组给予氢氯噻嗪;B组给予呋塞米。于服药开始及服药后3、6、12个月分别监测左室射血分数（LVEF）、血尿酸、空腹血糖、血肌酐及血清钾等指标,并进行6min步行试验。结果2组治疗6个月后,LVEF、6min步行试验结果与治疗前相比,均显著增加（P〈0．05）;2组治疗前后血尿酸、空腹血糖、血肌酐及血清钾等均无显著改变（P〉0．05）。结论长期口服小剂量利尿剂治疗慢性收缩性心力衰竭的疗效可靠、安全。     

国产硝苯地平控释片联合小剂量氢氯噻嗪治疗高血压病合并糖尿病的疗效

目的观察国产硝苯地平控释片联合小剂量氢氯噻嗪片治疗高血压病合并糖尿病的疗效。方法对56例高血压病并糖尿病患者,口服硝苯地平控释片起始量为30 mg,qd;氢氯噻嗪片起始量12.5 mg,qd,均晨起时服药。1周后血压未达标者,第2周起硝苯地平控释片加量至60 mg,再未达标者,第3周起氢氯噻嗪片可加至25 mg,总疗程为6周。对治疗前后血压、血糖、HbA1c、尿酸、血脂、血钾、尿素氮及肌酐的变化进行比较。结果患者收缩压、舒张压治疗前分别为（164.26±17.84）mmHg、（108.50±8.80）mmHg,治疗后分别为（130.12±8.63）mmHg、（80.20±7.65）mmHg,二者比较差异有统计学意义（均P〈0.01）。血糖、HbA1c、尿酸、血脂、血钾、尿素氮及肌酐治疗前后比较差异均无统计学意义（均P〉0.05）。结论国产硝苯地平控释片联合小剂量氢氯噻嗪片对血糖无明显影响,是治疗高血压病并糖尿病平稳有效、安全经济、较为理想的联合降压药物。     

厄贝沙坦氢氯噻嗪片治疗高血压性心力衰竭疗效观察

[目的]研究和评价厄贝沙坦氢氯噻嗪片治疗高血压性心力衰竭的疗效和安全性。[方法]选择100例高血压性心力衰竭病人,在一般治疗基础上加用厄贝沙坦氢氯噻嗪片1片口服,疗程15d,观察其血压下降及心力衰竭改善情况。[结果]厄贝沙坦氢氯噻嗪片有效降低血压并改善心力衰竭症状。[结论]厄贝沙坦氢氯噻嗪片治疗高血压性心力衰竭有较好的疗效和安全性。     

Comparison of low doses of hydrochlorothiazide plus amiloride and hydrochlorothiazide alone in hypertension in elderly patients

A randomised, double-blind study comparing 25 mg of hydrochlorothiazide plus 2.5 mg of amiloride with 25 mg of hydrochlorothiazide alone was conducted in 40 elderly patients with mild to moderate hypertension. After 8 weeks of treatment, the target blood pressure, supine diastolic blood pressure less than 90 mm Hg, was obtained in 73% of the hydrochlorothiazide plus amiloride treated patients (n = 17) and in 41% of the hydrochlorothiazide treated patients (n = 19; p less than 0.05). However, there was no statistically significant difference in blood pressure reduction between the 2 groups. Four patients dropped out, 3 of them due to side-effects. Serum potassium and magnesium concentrations were reduced in the hydrochlorothiazide group and serum sodium concentration in the hydrochlorothiazide plus amiloride group. Our results suggest that in elderly hypertensive subjects, a higher proportion of patients could be managed with the low dose hydrochlorothiazide plus amiloride regimen than with the low dose hydrochlorothiazide regimen.     

Antihypertensive drug combinations: prazosin, hydrochlorothiazide and clonidine.

Fourty-six men and 6 women aged 45 years and having arterial hypertension newly diagnosed at routine medical examinations were given out-patient antihypertensive treatment with prazosin, prazosin + hydrochlorothiazide, or prazosin + hydrochlorothiazide + clonidine. The mean values of blood pressure after the 3-week placebo period were 157/109 mmHg in the supine and 160/115 mmHg in the standing position. Treatment with prazosin (1--2 mg t.i.d.) produced normotension in 4/52 patients only, yet supine diastolic blood pressure and standing blood pressure were significantly lowered within 9 weeks. The addition of hydrochlorothiazide (25 mg daily) for 3 weeks to the regimen led to normotension in 12/46 patients. The remaining 34 patients still having an average supine blood pressure of 152/106 mmHg after prazosin + hydrochlorothiazide, responded well to low doses of clonidine added for 6 weeks to the treatment. Only 7 patients having initially high blood pressure still had a diastolic blood pressure greater than or equal to 100 mmHg at the end of the trial. The subjective side-effects were frequent but mild being roughly similar during placebo and active drug periods, except that fatigue and dry mouth due to clonidine were common, yet tolerable. No "first tablet reactions" to low inital doses of prazosin were found.     

Ticrynafen and hydrochlorothiazide in hypertension.

In a double-blind study, 28 patients having mild to moderate essential hypertension were randomly assigned to a 6-week regimen of ticrynafen, hydrochlorothiazide, or placebo. Blood pressure fell after ticrynafen and hydrochlorothiazide. Serum uric acid fell strikingly with ticrynafen whereas it rose with hydrochlorothiazide. Serum potassium declined very little with ticrynafen; much less than with hydrochlorothiazide. Serum creatinine and blood urea nitrogen rose slightly more with ticrynafen than with hydrochlorothiazide. There were no clinical adverse effects to either of the medications. Ticrynafen appears to be an effective antihypertensive with a substantial hypouricemic effect.     

Antihypertensive efficacy of two low dosages of hydrochlorothiazide in patients treated with captopril

Twelve patients with essential hypertension (diastolic blood pressure, greater than 90 mmHg) after four weeks of treatment with captopril (50 mg BID) were randomly divided into two groups and treated with 12.5 mg and 25 mg of hydrochlorothiazide OD, in addition to captopril, in a crossover experimental design. Each dosage of hydrochlorothiazide was given for four weeks, with a two-week placebo washout period intervening. Both dosages of hydrochlorothiazide caused significant reductions in blood pressure. Eighty percent of patients achieved a diastolic blood pressure less than 90 mmHg during combination therapy, independent of the dose of diuretic. None of the patients reported significant side effects, and no changes were observed in routine biochemical analysis during treatment. In patients not completely controlled by captopril alone, a once-daily dosage of 12.5 mg of hydrochlorothiazide proved as effective as a 25-mg once-daily dosage. The smaller dosage could result in fewer unwanted metabolic effects induced by diuretic administration.     

The effects of benazepril, a new angiotensin-converting enzyme inhibitor, in mild to moderate essential hypertension: a multicenter study

Benazepril hydrochloride is a new angiotensin-converting enzyme inhibitor. In a multicenter study, 206 patients with mild to moderate hypertension were randomized to receive benazepril at a dose of 2, 5, 10, or 20 mg, hydrochlorothiazide, 25 mg, or placebo once daily for 4 weeks. The 20 mg dosage of benazepril lowered blood pressure to a degree equal to that of 25 mg hydrochlorothiazide: -12.2/7.7 mm Hg and -13.4/-7.5 mm Hg, respectively. Hydrochlorothiazide proved to be more effective in black subjects. At lower dosage levels of benazepril (2, 5, and 10 mg), blood pressure reduction was not significantly different from that with placebo. In those patients who failed to achieve goal diastolic blood pressure of less than 90 mm Hg with monotherapy after 4 weeks, the addition of open-label hydrochlorothiazide (25 mg/day) to benazepril, hydrochlorothiazide, or placebo produced a substantial additional decrease in blood pressure over a 2-week period. No definite adverse effects on hematologic measurements, serum biochemistry test results, or urinalyses were noted. Subjective adverse experiences were common in all groups but except in three or possibly four instances were not considered causally related to the study drug.     

初始联合治疗策略对高血压患者的疗效及肾功能的影响

【目的】探讨初始小剂量氨氯地平分别与复方阿米洛利和替米沙坦联合治疗高血压痛的效果及对肾功能的影响。【方法】302例50～79岁伴心血管病危险因素的原发性高血压患者随机分为A、B两组,起始治疗A组给予小剂量氨氯地平（2．5mg／d）＋复方阿米洛利（半片／d）,含阿米洛利1．25mg,氢氯嘧嗪12．5mg;B组给予氨氯地平＋替米沙坦（40mg／d）。二周后根据血压调整剂量,随访治疗一年,观察两种联合治疗方案对高血压患者的降压幅度、血压控制率、不良反应以及对血肌酐和内生肌酐清除率的影响。【结果】治疗前后A组与B组血压均显著降低,分别从（157．1±12．0）／（91．1±9．4）mmHg降至（128．1±10．3）／（76．6±8．0）mmHg和（156．4±13．6）／（91．2±9．5）mmHg降至（131．5±12．3）／（77．3±9．2）mmHg,P〈0．05;血压控制率分别为87．1％和76．5％（P=0．024）;B组血肌酐较治疗前降低[（85．15±21．25）μmmol／Lvs．（82．70±20．21）μmmol／L,P=0．001]。【结论】两种联合治疗方案均可以显著降低血压,初始联合治疗可以显著提高血压控制率;联合方案中配伍替米沙坦可能提供降压外的肾脏保护作用。     

Dose-effect and concentration-effect relationships of pinacidil and hydrochlorothiazide in hypertension

To determine dose-effect and concentration-effect relationships in hypertension for pinacidil and hydrochlorothiazide when given alone and together, we conducted a randomized, double-blind, 4 X 3 factorial, modified fixed-dose multicenter trial. Three hundred and eighty-four patients with essential hypertension (supine diastolic blood pressure, 95 to 110 mm Hg) were assigned to one of 12 groups that received all combinations of four doses of pinacidil (0, 12.5, 25, and 37.5 mg, b.i.d.) with three doses of hydrochlorothiazide (0, 12.5, and 25 mg, b.i.d.). Significant dose- and concentration-effect relationships were seen for pinacidil and hydrochlorothiazide on diastolic blood pressure. For pinacidil, dose- and concentration-effect relationships were steeper after the dose than before the dose. A significant interaction with hydrochlorothiazide was noted such that, when combined with 12.5 mg hydrochlorothiazide, 12.5 mg pinacidil had near-maximal effects on blood pressure at both peak and trough. Edema occurred in 47% of those who received 37.5 mg pinacidil monotherapy (19% discontinued). The administration of 12.5 mg pinacidil with 12.5 mg hydrochlorothiazide appears to be optimal for efficacy and safety.     

Captopril and oxprenolol in a fixed combination with thiazide diuretics: comparison of their antihypertensive efficacy and metabolic effects

After receiving placebo for two weeks, 20 patients with essential hypertension were randomly divided into two groups. Those in group 1 received a combination of 25 mg of captopril (CPT) and 25 mg of hydrochlorothiazide (HCT) BID. Those in group 2 received a combination of 80 mg of oxprenolol (OXP) and 10 mg of chlorthalidone (CHLT) BID. Patients whose recumbent diastolic blood pressure was less than 95 mmHg after four weeks of treatment continued with the same regimen for six more weeks, while the dosages were doubled for nonresponders. All the patients in group 1 had satisfactory blood pressure readings after the first four weeks of therapy; six patients in group 2 required double dosages to control their blood pressure. Both drug combinations reduced patients' recumbent systolic blood pressure, but CPT + HCT reduced their diastolic and standing systolic blood pressure more effectively. Doubling the dosages of OXP + CHLT was only slightly more effective in controlling patients' blood pressure. In addition, patients who received CPT + HCT showed a significant decrease in serum sodium level, whereas patients who received the double dosages of OXP + CHLT showed a significant increase in serum cholesterol and creatinine levels. The data suggest that low dosages of CPT + HCT control blood pressure more effectively than high dosages of OXP + CHLT and, in addition, do not have any negative metabolic effects.