坎地沙坦酯治疗轻中度原发性高血压疗效观察

目的评价坎地沙坦酯治疗轻中度原发性高血压的疗效、安全性。方法采用随机双盲分组试验,120例轻中度原发性高血压患者随机分为：坎地沙坦酯组（60例）和缬沙坦组（60例）,分别每天一次口服坎地沙坦酯8mg或缬沙坦80mg。药物治疗前、后行24h动态血压监测。结果①8周末,两组坐位收缩压（SBP）谷值及坐位舒张压（DBP）谷值均较基线明显下降,坎地沙坦酯组的SBP谷值及DBP谷值下降幅度大于缬沙坦组;②坎地沙坦酯降低轻中度高血压的有效率高于缬沙坦。结论①坎地沙坦酯8mg每天一次口服治疗轻中度原发性高血压安全、有效;②坎地沙坦酯8mg每天一次口服降压作用可维持24h。     

国产坎地沙坦酯与依那普利治疗原发性轻中度高血压疗效比较

目的：探讨国产坎地沙坦酯对原发性轻中度高血压患者的疗效和安全性。方法：将60例原发性轻中度高血压患者随机分为坎地沙坦酯组和依那普利组,采用双盲双模拟平行对照研究。经过2周的安慰剂清洗期后两组患者分别接受坎地沙坦酯8mg／d或依那普利10mg／d。4周后若达到预期降压效果,则继续原剂量服药至8周。如降压效果不理想,加用氢氯噻嗪片（每次12．5mg,每日1次）,继续服药4周。观察所有入选患者8周内的血压、不良反应和生化指标变化。结果：治疗结束时坎地沙坦酯组收缩压下降20．2mmHg（1mmHg=0．133kPa）,舒张压下降13．9mmHg;依那普利组收缩压下降19．6mmHg,舒张压下降13．8mmHg。两组相比差异无统计学意义。两组均未见严重不良反应。结论：国产坎地沙坦酯治疗原发性轻中度高血压安全、有效。     

国产苯磺酸氨氯地平治疗慢性肾功能不全高血压的临床观察

目的 评价国产苯磺酸氨氯地平（兰迪）治疗慢性肾功能不全高血压的降压疗效和安全性。方法 慢性肾功能不全高血压病患者60例．给予苯磺酸氨氯地平5mg／d治疗4周，治疗4周末坐位DBP〈80mmHg，且SBP≤130mmHg者继续原剂量治疗至8周末；坐位DBP〉90mmHg或SBP〉140mmHg者剂量分别加倍至10mg每日1次治疗至8周末。分别观察患者服药前后血压、心率和肝肾功能等生化指标变化及其不良反应。结果 60例患者均完成8周的临床试验。与试验前比较．用药第4周起，患者的收缩压和舒张压均有显著性下降（P〈0．01），降压总有效率达83．3％。不良反应轻而少。结论 国产苯磺酸氨氯地平治疗慢性肾功能不全合并轻中度肾性高血压有效，且安全。     

坎地沙坦酯联合小剂量氢氯噻嗪治疗轻中度原发性高血压临床观察

目的：观察坎地沙坦酯联合小剂量氢氯噻嗪治疗轻中度高血压的临床疗效和安全性。方法：采用随机平行对照,选择轻中度高血压患者105例,随机加入坎地沙坦酯联合（坎地沙坦酯4～8mg和氢氯噻嗪12．5mg口服,1次／天）治疗组,坎地沙坦酯（坎地沙坦酯4～8mg口服,1次／天）治疗组,共8周。比较治疗前、治疗4和8周末血压、心率、血、尿常规、血糖、肾功、离子、血尿酸、临床表现变化。结果：（1）两组患者心率治疗前后无统计学差异（P〉0．05）。（2）治疗4和8周末．两组的坐位收缩压和舒张压均较治疗前显著降低（P〈0．05）．坎地沙坦酯联合组较坎地沙坦酯组下降幅度更明显（P〈0．05）。（3）两组患者降压总有效率有显著性差异（P〈0．05）。（4）不良事件的发生两组无显著差异（P〉0．05）,无严重不良事件发生;血清钾、血尿酸治疗前后统计学处理无差异（P〉0．05）。结论：坎地沙坦酯与小剂量氢氯噻嗪联合治疗轻中度高血压的降压效果强于坎地沙坦酯．安全耐受。     

国产坎地沙坦酯与厄贝沙坦治疗原发性轻中度高血压疗效比较

目的探讨国产坎地沙坦酯对原发性轻中度高血压患者的疗效和安全性。方法60例原发性轻中度高血压患者,随机分为坎地沙坦酯和厄贝沙坦组,每组30例,采用双盲双模拟平行对照研究。经过2周的安慰剂清洗期后两组患者分别接受坎地沙坦酯片一日8mg或厄贝沙坦片一日150mg。2周后如果达到预期降压效果,则继续原剂量服药至4周末。如降压效果不理想,加量(坎地沙坦酯一日12mg或厄贝沙坦一日225mg)继续服药2周。观察所有入选患者4周内的血压、不良反应和生化指标变化。结果治疗结束时坎地沙坦酯组收缩压下降15.1%,舒张压下降12.2%;厄贝沙坦组收缩压下降12.6%,舒张压下降9.2%。两组相比无显著差异。两组均未见严重不良反应。结论国产坎地沙坦酯为治疗原发性轻中度高血压安全且有效的药物。     

高剂量坎地沙坦西酯16mg治疗轻中度原发性高血压65例临床观察

目的:评价16 mg坎地沙坦西酯治疗轻中度原发性高血压患者的有效性和安全性.方法:采用随机、双盲、平行对照的研究方法,入选患者65例,随机接受坎地沙坦西酯16 mg·d-1(n=33)或8 mg·d-1(n=32)治疗,共8周,并对其中的37例患者于治疗前后进行24 h动态血压监测.结果:治疗8周末,16 mg组和8 mg组的收缩压分别下降(10.9±11.5)mmHg和(11.5±15.1)mmHg,舒张压分别下降(12.9±11.3)mmHg和(10.5±7.8)mmHg;两组的降压总有效率分别为70%和61.3%.动态血压监测显示,16 mg组和8 mg组的收缩压谷峰比值分别为73%和47%,舒张压为65%和47%.两组的不良事件发生率无统计学差异.结论:高剂量坎地沙坦西酯16 mg·d-1治疗轻中度原发性高血压安全有效,患者耐受性好.     

坎地沙坦酯治疗原发性高血压的临床疗效

目的观察坎地沙坦酯治疗原发性高血压的临床疗效。方法选择200例轻、中度高血压患者随机分成两组,试验组给予坎地沙坦酯8mg/d,对照组给予氯沙坦钾50mg/d,连续服用4周,如未降到目标血压(140mmHg/90mmHg以下)者则将用药剂量加倍维持到第8周末,观察两组患者用药前后的血压变化情况。结果试验组和对照组患者的血压均得到明显下降(P<0.01)试验组显效率为54.8%,总有效率为87.9%,对照组显效率为61.3%,总有效率为84.1%,两组之间差异无显著性(P>0.05)。结论本次观察结果证明坎地沙坦酯治疗原发性高血压疗效确切耐受性好,不良反应少服用安全。     

国产坎地沙坦酯与依那普利治疗原发性轻中度高血压疗效比较

目的:探讨国产坎地沙坦酯对原发性轻中度高血压患者的疗效和安全性。方法:将60例原发性轻中度高血压患者随机分为坎地沙坦酯组和依那普利组,采用双盲双模拟平行对照研究。经过2周的安慰剂清洗期后两组患者分别接受坎地沙坦酯8 mg/d或依那普利10 mg/d。4周后若达到预期降压效果,则继续原剂量服药至8周。如降压效果不理想,加用氢氯噻嗪片(每次12.5 mg,每日1次),继续服药4周。观察所有入选患者8周内的血压、不良反应和生化指标变化。结果:治疗结束时坎地沙坦酯组收缩压下降20.2 mm Hg(1 mm Hg=0.133 kPa),舒张压下降13.9mm Hg;依那普利组收缩压下降19.6 mm Hg,舒张压下降13.8 mm Hg。两组相比差异无统计学意义。两组均未见严重不良反应。结论:国产坎地沙坦酯治疗原发性轻中度高血压安全、有效。     

坎地沙坦和培哚普利治疗原发性高血压的疗效比较

目的:探讨坎地沙坦治疗轻、中度原发性高血压的疗效及安全性.方法:将80例临床确诊为轻、中度原发性高血压患者随机分为治疗组(坎地沙坦组)38例,每日早晨服坎地沙坦8mg;对照组(培哚普利组)42例,每日早晨服培哚普利4mg.两组疗程均为8周.治疗前后观察血压变化、血钾、肝功能、肾功能.结果:服药第8周两观察组血压均较治疗前显著降低(P<0.001),且坎地沙坦的降压作用较培哚普利明显(P<0.001).到第8周末坎地沙坦组与培哚普利组降压总有效率分别为94.3%与89.7%.与观察开始前比较,第8周末血钾,肝功能、肾功能无明显改变.结论:坎地沙坦对轻,中度原发性高血压患者有良好降压效果,服用安全.     

坎地沙坦治疗原发性高血压疗效及安全性分析

目的 观察血管紧张素Ⅱ受体拮抗剂坎地沙坦治疗轻、中度原发性高血压患者的疗效和安全性.方法 82例原发性高血压患者随机分成两组,分别予以坎地沙坦(8 mg·d-1),贝那普利(10 mg·d-1),8周后观察降压效果和降压谷峰比值(T/P).结果 坎地沙坦组和贝那普利组的血压均明显下降P＜0.05,总有效率分别为64%和62%,无显著性差异(P＞0.05).降压谷峰比值:坎地沙坦组SBP/DBP为0.85/0.83;贝那普利组SBP/DBP为0.68/0.64,前者显著高于后者(P＜0.05).结论 坎地沙坦(8 mg·d-1),对轻、中度原发性高血压降压疗效确切,谷峰比值高.     

坎地沙坦酯片治疗原发性高血压118例

目的:比较国产坎地沙坦酯片与氯沙坦治疗轻、中度原发性高血压的疗效和安全性。方法:多中心、随机、双盲、双模拟、阳性药平行对照试验。经2 wk安慰剂导入期,238例原发性高血压病人进入8 wk治疗期,每日1次服用坎地沙坦酯片8 mg(n=118),或氯沙坦片50 mg(n=120),2 wk后如舒张压≥12 kPa则剂量加倍。结果:2组病人的血压均得到明显地降低(P<0.01);坎地沙坦酯组总有效率为82.2%,氯沙坦组为84.2%,2组间没有显著差异。坎地沙坦酯组和氯沙坦组收缩压和舒张压的降压谷峰(T/P)比值分别为0.75,0.71和0.76,0.94。结论:对轻、中度原发性高血压病人坎地沙坦酯片是一种有效、安全且易耐受的降压药,每日1次能维持24 h降压效应。     

坎地沙坦与氯沙坦治疗原发性高血压的疗效及对肾脏的保护作用

目的比较坎地沙坦与氯沙坦治疗原发性高血压的临床疗效及对肾脏的保护作用。方法将本院诊治的72例轻中度原发性高血压病患者随机分为坎地沙坦组与氯沙坦组,两组分别给予坎地沙坦口服,8 mg/d,氯沙坦50 mg/d,疗程8周。比较两组治疗前后24 h动态血压改变、心率震荡初始值(TO)、心率震荡斜率(TS)及肾功能指标的变化。结果坎地沙坦组与氯沙坦组治疗有效率分别为84.2%和82.4%,两组比较差异无统计学意义(P>0.05);坎地沙坦组治疗后24 h收缩压(SBP)及24 h舒张压(DBP)分别为(121.45±10.23)mmHg和(76.24±6.03)mmHg,氯沙坦组分别为(122.39±10.16)mmHg和(76.53±6.21)mmHg,两组比较差异无统计学意义(P>0.05),但坎地沙坦组清晨血压SBP及DBP下降值分别为(13.90±3.32)mmHg和(9.80±2.17)mmHg,显著优于氯沙坦组(10.23±2.87)mmHg和(7.33±2.01)mmHg(P<0.05);坎地沙坦组与氯沙坦组治疗后TO分别为(0.38±0.23)%、(0.40±0.25)%,TS为(5.16±0.83)ms/RRI、(5.09±0.78)ms/RRI,差异无统计学意义(P>0.05);坎地沙坦组治疗后24 h尿蛋白及尿β2-MG分别为(134.90±19.21)mg和(1.88±0.43)mmol/L,氯沙坦组分别为(136.73±18.70)mg和(1.87±0.41)mmol/L,两组均显著优于治疗前(P<0.05);两组治疗后BUN、SCr与治疗前比较差异无统计学意义(P>0.05);氯沙坦组治疗后尿酸水平显著低于坎地沙坦组(312.20±18.93)vs(339.84±18.74)μmol/L,P<0.05。结论坎地沙坦与氯沙坦治疗轻中度高血压均有较好疗效,对肾脏具有保护作用。但坎地沙坦控制清晨血压效果更为理想,氯沙坦可显著降低尿酸水平,临床可根据患者病情选用药物。     

坎地沙坦酯治疗轻中度原发性高血压的疗效及安全性观察

目的观察坎地沙坦酯治疗轻、中度原发性高血压病的疗效及安全性。方法 90例患者分为治疗组和对照组各45例。治疗组给予坎地沙坦酯片,对照组给予缬沙坦片。2组疗程均为8周。观察2组降压疗效、BP、HR、24h动态血压及T/P比值变化、不良反应情况。结果治疗组降压总有效率为91.1%,对照组为88.9%,差异无统计学意义（P〉0.05）;2组治疗2、4、6、8周SBP、DBP均低于治疗前,差异有统计学意义（P〈0.01）,但2组比较差异无统计学意义（P〉0.05）;治疗组治疗后HR为（74±6）次/min,对照组为（74±7）次/min,2组比较差异无统计学意义（P〉0.05）;2组治疗后24h、日间和夜间血压均低于治疗前,差异有统计学意义（P〈0.05）,但2组比较差异无统计学意义（P〉0.05）;治疗组SBP和DBP的T/P比值分别为0.75和0.71,对照组为0.76和0.94;治疗组不良反应发生率为8.9%,对照组为11.1%,2组比较差异无统计学意义（P〉0.05）,且不良反应轻微。结论坎地沙坦酯片治疗轻、中度原发性高血压安全、有效,患者耐受性良好,值得临床推广应用。     

坎地沙坦酯治疗轻、中度原发性高血压的临床研究

目的 观察坎地沙坦酯片治疗轻、中度原发性高血压的疗效.方法 采用随机、单盲、平行对照试验.将110例原发性高血压患者随机分为治疗组和对照组各55例.治疗组给予坎地沙坦酯片8mg口服治疗,1次/d;对照组给予缬沙坦片80mg口服治疗,1次/d.服用2周后,若舒张压≥12kPa则剂量加倍,疗程为8周.比较2组的降压疗效、幅度及心率变化.结果 治疗组总有效率为90.9%,对照组的87.3%,2组比较无显著差异（P〉0.05）.2组治疗前、后血压降低幅度均有显著差异（P〈0.01）,但2组间比较无显著差异（P〉0.05）.2组治疗前、后心率均无明显变化,组间比较无显著差异（P〉0.05）.结论 坎地沙坦酯片治疗轻、中度原发性高血压疗效确切,不良反应少,患者耐受性良好,临床应用安全,值得临床推广应用     

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.     

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。     

Switch from ABCD pretreatment to A-II-A treatment: a multinational, open, centrally randomized, prospective parallel group comparison

The aim of this trial was to evaluate the efficacy and safety of switching antihypertensive monotherapy from a non-angiotensin II receptor blocker treatment, i.e., angiotensin-converting enzyme (ACE) inhibitor, beta-blocker, calcium (Ca2+) channel blocker or diuretic, to monotherapy with candesartan cilexetil 8 or 16 mg once daily. Patients (age 18-74 years) with mild to moderate essential hypertension were enrolled in this multinational, open-label, centrally randomized, prospective parallel group study. Previous antihypertensive treatment, with either an ACE inhibitor, a beta-blocker, a Ca2+ channel blocker or a diuretic, was maintained for a run-in period of 4 weeks and was then substituted at the baseline visit where patients were randomized into two groups to receive either candesartan cilexetil 8 mg (n = 985) or 16 mg (n = 982) once daily for an 8-week treatment period. Blood pressure (BP) reduction was the primary endpoint after 4 weeks of therapy and the secondary endpoint after 8 weeks of therapy. Results of the first 4 weeks of therapy are presented here. A total of 1,967 patients were included: 985 received candesartan cilexetil 8 mg and 982 candesartan cilexetil 16 mg once daily; 1,879 patients were included in the intention-to-treat analysis. The percentages of patients receiving an ACE inhibitor, a beta-blocker, a Ca2+ channel blocker or a diuretic as previous antihypertensive treatment were 44.7, 18.8, 30.6 and 5.9%, respectively. After 4 weeks of treatment with candesartan cilexetil 8 and 16 mg, sitting diastolic and systolic BP were reduced (mean +/- SD): -7 +/- 10 and -14 +/- 17 mmHg, and -8 +/- 10 and -16 +/- 16 mmHg, respectively. The percentage of patients who were still borderline hypertensive or hypertensive after 4 weeks of substitute treatment was lower in the candesartan cilexetil 16 mg group than in the 8 mg group: 7.1 and 5.3%, respectively, versus 9 and 7.4%, respectively. Reported adverse events were mild or moderate in intensity and in accordance with those reported in the literature. Candesartan cilexetil can be considered an effective and safe alternative to other common antihypertensive monotherapies in a large spectrum of patients with mild and moderate hypertension.     

Efficacy and tolerability of candesartan cilexetil/hydrochlorothiazide and amlodipine in patients with poorly controlled mild-to-moderate essential hypertension.

The antihypertensive efficacy and tolerability of combination therapy with candesartan cilexetil, 16 mg plus hydrochlorothiazide (CC/HCTZ), 12.5 mg was compared with that of amlodipine, in a multicentre, double-blind, randomised, parallel-group study in patients with mild-to-moderate essential hypertension inadequately controlled by monotherapy. After a two week run-in period on existing therapy, patients with a sitting diastolic blood pressure (DBP) of 90-110 mmHg and a sitting systolic blood pressure (SBP) 相似文献   

国产氨氯地平治疗慢性肾功能不全并高血压的临床观察

目的 评价国产氨氯地平(兰迪)治疗慢性肾功能不全合并轻中度高血压的降压疗效和安全性.方法 慢性肾功能不全(血清肌酐值265-442 μmol/L)合并高血压患者61例,随机分为两组:兰迪组(31例)、氨氯地平组(络活喜组,30例),分别服用兰迪或络活喜5 mg每日1次,治疗4周末坐位DBP＜80 mm Hg且SBP＜130 mm Hg者继续原剂量治疗至8周末;坐位DBP≥80 mm Hg或SBP≥130 mm Hg者剂量分别加倍至10 mg 每日1次治疗至8周末.分别观察患者服药前后血压、心率和肝肾功能等生化指标变化及其不良反应.结果 61例患者均完成8周的临床试验.降压总有效率兰迪组达87%,络活喜组达90%,若以血压为130/80 mm Hg为靶目标值则:兰迪组8周后11例(36%)达标;络活喜组9例(30%)达标.两组不良反应轻,试验结束时主要实验室检查指标与试验前比较差异无统计学意义.结论 国产氨氯地平(兰迪)5～10 mg,每日1次是治疗慢性肾功能不全合并轻中度肾性高血压有效药物之一,且安全性好.