氯沙坦与吲达帕胺或氢氯噻嗪合用的降压疗效观察

目的:研究和评价氯沙坦与吲达帕胺或氢氯噻嗪合用降压疗效及对代谢的影响.方法:选择45例轻-中度原发性高血压患者,随机分成3组,每组各15例.氯沙坦组:单用氯沙坦50～100 mg,每日一次;氯沙坦与吲达帕胺合用组:氯沙坦50 mg,每日一次,加吲达帕胺2.5 mg,每日一次;氯沙坦与氢氯噻嗪合用组:氯沙坦50 mg, 每日一次,加氢氯噻嗪12.5 mg,每日二次.三组疗程均为12周.观察三组治疗前后的随测血压(CBP)和24小时动态血压(ABPM)及生化指标.结果:氯沙坦加吲达帕胺或加氢氯噻嗪组降压总有效率及随测血压、24小时动态血压的变化均明显优于氯沙坦单用组,且治疗前后心率和生化指标无明显改变.结论:氯沙坦与吲达帕胺或氢氯噻嗪联合应用降压效果较单用氯沙坦更有效, 且对代谢无影响.     

氯沙坦与吲达帕胺或氢氯噻嗪合用的降压疗效观察

目的 :研究和评价氯沙坦与吲达帕胺或氢氯噻嗪合用降压疗效及对代谢的影响。方法 :选择 45例轻—中度原发性高血压患者 ,随机分成 3组 ,每组各 15例。氯沙坦组 :单用氯沙坦 5 0～ 10 0mg ,每日一次 ;氯沙坦与吲达帕胺合用组 :氯沙坦 5 0mg ,每日一次 ,加吲达帕胺 2 .5mg ,每日一次 ;氯沙坦与氢氯噻嗪合用组 :氯沙坦 5 0mg ,每日一次 ,加氢氯噻嗪 12 .5mg ,每日二次。三组疗程均为 12周。观察三组治疗前后的随测血压 (CBP)和 2 4小时动态血压 (ABPM)及生化指标。结果 :氯沙坦加吲达帕胺或加氢氯噻嗪组降压总有效率及随测血压、2 4小时动态血压的变化均明显优于氯沙坦单用组 ,且治疗前后心率和生化指标无明显改变。结论 :氯沙坦与吲达帕胺或氢氯噻嗪联合应用降压效果较单用氯沙坦更有效 ,且对代谢无影响     

氯沙坦钾氢氯噻嗪片联合硝苯地平控释片对老年顽固性单纯收缩期高血压患者肾功能的影响

目的研究氯沙坦钾氢氯噻嗪片联合硝苯地平控释片对老年顽固性单纯收缩期高血压患者各项肾功能指标水平的影响。方法收集120例老年顽固性单纯收缩期高血压患者,随机将其分为对照组60例、研究组60例。对照组予口服氯沙坦钾氢氯噻嗪片62.5 mg/次,1次/d;研究组予口服氯沙坦钾氢氯噻嗪片(62.5 mg/次,1次/d)联合硝苯地平控释片30 mg/次,1次/d。治疗3个月后,观察记录并比较研究组及对照组血压变化情况及肾功能指标水平。结果研究组血压下降水平较对照组更明显且肾功能改善更明显(均P0.05)。结论氯沙坦钾氢氯噻嗪片联合硝苯地平控释片能明显改善老年顽固性单纯收缩期高血压患者的肾功能。     

氯沙坦与吲哒帕胺或氢氯噻嗪合用的降压疗效观察

目的：研究和评价氯沙坦与吲哒帕胺或氢氯噻嗪合用降压疗效及对代谢的影响。方法：选择４５例轻一中度原发性高血压患者,随机分成３组,氯沙坦与吲达帕胺合用组：氯沙坦５０ｍｇ,每日一次,加吲达帕胺２．５ｍｇ,每日一次;氯沙坦与氢氯噻嗪合用组：氯沙坦５０ｍｇ,每日一次,加氢氯噻嗪１２．５ｍｇ,每日二次。三组疗程均为１２周。观察三组治疗前后的随测血压（ＣＢＰ）和２４小时动态血压（ＡＢＰＭ）及生化指标。结果：氯沙坦加吲达帕胺或加氢氯噻嗪组降压总有效率及随测血压、２４小时动脉血压的变化均明显优于氯沙坦单用组,且治疗前后心率和生化指标无明显改变。结论：氯沙坦与吲达帕胺或氢氯噻嗪联合应用降压效果较单用氯沙坦更有效,且对代谢无影响。     

氯沙坦联用氢氯噻嗪对高血压合并高尿酸血症患者的治疗效果

目的:探讨氯沙坦联用氢氯噻嗪对高血压合并高尿酸血症患者血压和血尿酸的影响。方法:入选诊断为原发性高血压合并高尿酸血症,且口服氯沙坦100 mg/d4周以上血压未达标的患者55例,改为每日口服氯沙坦50 mg和氢氯噻嗪12.5 mg复方制剂,共12周。观察药物联合治疗前后患者血压和血尿酸水平的变化。结果:氯沙坦联合氢氯噻嗪治疗后,患者平均收缩压、平均舒张压水平明显下降,分别为(148±11)mmHg对(133±14)mmHg和(91±8)mmHg对(84±9)mmHg(P<0.001),而血尿酸水平无显著变化。结论:对于单用氯沙坦降压效果不显著的高血压合并高尿酸血症患者,氯沙坦联用氢氯噻嗪可明显降低血压水平,且对血尿酸水平无显著影响。     

海捷亚和科素亚双盲、随机、对照降压疗效临床研究

目的 本研究所旨在对比评价氯沙坦钾／氢氯噻嗪（海捷亚组）和氯沙坦钾（科素亚）治疗原发性高血压病的疗效、安全性和耐受性。方法 179例原发性高血压门诊患者（舒张压95mmHg-115mmHg)参加了双盲、随机对照的临床治疗研究。经过2周安慰剂洗脱期后,患者被随机分入海捷亚组（氯沙坦钾加氢氯噻嗪）,或科素亚组（氯沙坦钾50mg-100mg),每日服药一次。168例患者完成了8周治疗研究。疗效判定标准为4,8周DBP血压下降到正常或下降10－19mmHg以上为有效。结果 两组血压均较药前显著下降。海捷亚有效率81．9％（4周）,88．0％（8周）较单纯科素亚组的41．2％和50．6％组高。两组间心率和不良反应为15％－19％,两组无明显差异。结论 氯沙坦钾片和氢氯噻嗪 联合使用氯噻嗪联合使用治疗发性高血压疗效比单用氯沙坦钾片好。海捷亚的安全性和耐受性同科素亚。     

海捷亚治疗老年原发性高血压的观察

目的：观察海捷亚对老年高血压的治疗作用及对靶器官的影响。方法：40例老年高血压患者口服海捷亚（氯沙坦50mg，氢氯噻嗪12.5mg)1片，每日一次，共8周，治疗前后测血压及行24h动态血压监测（ABPM）。结果：治疗第1周有效率50%，第2周达67.5%，服药4周总有效率达73.3%;谷峰比（T/P）SBP78%，DBP77%；对75.8%患者异常的血压昼夜节律有逆转作用；不良反应轻微，对心率，血钾，尿酸影响较小，结论：海捷亚能快速，平稳控制血压。     

卡托普利与小剂量氢氯噻嗪合用治疗高血压疗效观察

目的:研究卡托普利与小剂量氢氯噻嗪合用对高血压患者的疗效及对代谢的影响.方法:50例原发性高血压患者随机分为两组,第1组:单用卡托普利12.5 mg～7 5 mg,每日2～3次.第2组:卡托普利12.5 mg,每日2次,加服氢氯噻嗪12.5 mg,每日1次,两组治疗时间均为8周,测定治疗前后的基础血压,空腹血糖、血脂、血钾、血尿酸、尿素氮、肌酐, 以及治疗前后的24小时动态血压.结果:卡托普利加小剂量氢氯噻嗪组的总有效率及24小时动态血压结果均明显优于单用卡托普利组,而且两组治疗前后的代谢指标均无明显改变.结论:卡托普利与小剂量氢氯噻嗪合用治疗高血压较单用卡托普利更有效,而且对代谢无明显影响.     

海捷亚和科素亚双盲、随机、对照降压疗效临床研究

目的本研究旨在对比评价氯沙坦钾/氢氯噻嗪(海捷亚组)和氯沙坦钾(科素亚)治疗原发性高血压病的疗效、安全性和耐受性。方法179例原发性高血压门诊患者（舒张压95mmHg～115mmHg）参加了双盲、随机对照的临床治疗研究。经过2周安慰剂洗脱期后,患者被随机分入海捷亚组(氯沙坦钾加氢氯噻嗪),或科素亚组(氯沙坦钾50mg～100mg),每日服药一次。168例患者完成了8周治疗研究。疗效判定标准为4,8周DBP血压下降到正常或下降10～19mmHg以上为有效。结果两组血压均较药前显著下降。海捷亚有效率81.9%(4周),88.0%(8周)较单纯科素亚组的41.2%和50.6%组高。两组间心率和不良反应为15%～19%,两组无明显差异。结论氯沙坦钾片和氢氯噻嗪联合使用治疗原发性高血压疗效比单用氯沙坦钾片好。海捷亚的安全性和耐受性同科素亚。     

氯沙坦、氢氯噻嗪联合治疗原发性高血压的临床观察

目的:观察氯沙坦与氢氯噻嗪联合治疗原发性高血压患者的起效时间、疗效及不良反应等。方法:通过57例原发性高血压患者自身前后对照的开放性临床试验,在停用原降压药1周后即给予氯沙坦50mg和氢氯噻嗪12.5mg联合治疗,连续治疗4周,观察血压、心率、血钾、不良反应等指标。结果:两药联合应用可以比较迅速而有效的降低血压,第1周有效率可达63.2％,到第4周总有效率达92.8％。患者的耐受性好,不良反应小。结论:两药联合治疗原发性高血压是值得临床推荐的用药方式。     

拜新同与科素亚或海捷亚合用的降压疗效观察

目的研究和评价拜新同与科素亚或海捷亚合用降压疗效及对代谢的影响。方法选择45例中、重度原发性高血压患者,随机分成3组,每组各15例。拜新同组:单用拜新同30mg,每日1次;拜新同与科素亚合用组:拜新同30mg,每日1次,加科素亚50mg,每日1次;拜新同与海捷亚合用组:拜新同30mg,每日1次,加海捷亚50mg,每日1次。3组疗程均为12周。观察3组治疗前后的随测血压(CBP)和24h动态血压(ABPM)及生化指标。结果拜新同加海捷亚组降压总有效率及CBP、ABPM的变化均明显优于拜新同单用组和拜新同与科素亚合用组。治疗前后心率和生化指标则无明显改变。结论拜新同与海捷亚联合应用降低中、重度高血压效果较单用拜新同组以及拜新同和科素亚合用组更有效,且对代谢无影响。     

Effect of timolol plus hydrochlorothiazide plus hydralazine on essential hypertension.

The effect on hypertension of hydrochlorothiazide 100 mg daily plus timolol 20-60 mg daily versus hydrochlorothiazide plus placebo and of hydrochlorothiazide plus timolol plus hydralazine 40-200 mg daily versus hydrochlorothiazide plus placebo plus hydralazine was evaluated in a double-blind, randomized, crossover study in 38 patients with hypertension. Hydrochlorothiazide plus timolol was more effective than hydrochlorothiazide plus placebo in lowering both supine and standing systolic and diastolic blood pressures. Hydrochlorothiazide plus timolol plus hydralazine was a very effective regimen in lowering both supine and standing systolic and diastolic blood pressure. The patients tolerated this regimen well with greater hypotensive activity and a lower incidence of side effects than on hydrochlorothiazide plus placebo plus hydralazine.     

应用动态血压监测评价氯沙坦治疗原发性高血压的降压疗效

目的：应用动态血压监测（ＡＢＰＭ）评估氯沙坦（ｌｏｓａｒｔａｎ）５０～１００ ｍｇ,每日１次,对轻、中度原发性高血压（ＥＨ）患者的２４小时降压效果。 方法：轻、中度ＥＨ患者 ３３例,服用 ２周安慰剂,坐位舒张压仍在 ９５～１１４ ｍｍＨｇ（１ ｍｍＨｇ＝０．１３３ ｋＰａ）者予氯沙坦５０ ｍｇ／ｄ,服药 ２周末血压下降未达有效标准者氯沙坦增加至 １００ ｍｇ／ｄ,氯沙坦治疗疗程共 ６周。于服安慰剂末及治疗２、４、６周末测诊室血压,于服安慰剂末及治疗６周末应用ＡＢＰＭ。 结果;氯沙坦治疗６周,降压总有效率为８７．５％;２４小时各时点血压均较治疗前显著下降（Ｐ＜０．０５、Ｐ＜０．０１）,不伴有心率及血压昼夜节律的改变;降低收缩压和舒张压的谷／峰值分别为５２．９％和６３．６％。能明显降低血尿酸（Ｐ＜０．０５）。除１例因头晕中途退出研究外,余不良反应轻微。 结论：氯沙坦 ５０～１００ ｍｇ,每日１次能平稳、有效地控制 ＥＨ患者 ２４小时血压,且患者总体耐受良好。     

厄贝沙坦氢氯噻嗪片对老年高血压患者血管内皮功能的短期影响

目的 评价厄贝沙坦氢氯噻嗪片对老年高血压患者血管内皮功能的短期影响.方法 选择轻、中度原发性高血压患者106例,分为氢氯噻嗪组50例及厄贝沙坦氢氯噻嗪组56例,两组患者每日晨起分别口服氢氯噻嗪片25 mg及厄贝沙坦氢氯噻嗪片1片,连续12周,检测治疗前后患者的血压、血生化、高敏C反应蛋白（hs-CRP）、血管性血友病因子（vWF）等指标,以及肱动脉内皮依赖性舒张功能（EDD）和颈动脉内膜中层厚度（IMT）的变化.结果 与治疗前比较,氢氯噻嗪组患者治疗后收缩压、舒张压、血钾明显降低（P ＜0.05或P＜0.01）,尿酸明显升高（P＜0.01）,治疗前后vWF、EDD、IMT比较差异无统计学意义（P＞0.05）;厄贝沙坦氢氯噻嗪组患者治疗后收缩压、舒张压、hs-CRP及vWF均明显降低（P＜0.05或P＜0.01）,EDD明显提高（P＜0.05）,治疗前后IMT比较差异无统计学意义（P＞0.05）.两组患者治疗后比较,vWF、EDD比较差异有统计学意义（P＜0.05）.结论 老年轻、中度原发性高血压患者的血管内皮功能的损伤可以逆转,厄贝沙坦氢氯噻嗪片在降压同时可以改善受损的血管内皮功能.     

Central and peripheral hemodynamic effects of losartan and in combination with hydrochlorothiazide in mild to moderate essential hypertension

Background: Angiotensin II antagonists have proved to be effective antihypertensive agents with organoprotective properties. We aimed to clarify the effects of losartan and its combination with hydrochlorothiazide on 24-h blood pressures (BPs), central hemodynamics and microcirculation in essential hypertension (EH). Methods: Forty patients with mild to moderate EH were randomly allocated to receive losartan 50 mg (group I) or losartan 50 mg in combination with hydrochlorothiazide, 12.5 mg (group II). At baseline, week 2 and 8, ambulatory BP monitoring (ABPM), central hemodynamics monitoring and microcirculation investigation were performed. Results: In both groups, 24-h, daytime and night-time systolic (SBP) and diastolic (SBP) significantly decreased at week 8. DBP decreased more than SBP. Both drug regimens led to significant decrease in total peripheral vascular resistance; stroke and cardiac indexes remained unchanged. Losartan and its combination with hydrochlorothiazide improved main parameters of microcirculation. The index of microcirculation increased, as did the amplitude of cardiodependent and low frequency waves. Conclusions: Losartan monotherapy and losartan in combination with hydrochlorothiazide are effective antihypertensive agents. The BP-lowering effect is realized through reduction of total peripheral vascular resistance. Moreover, both drug regimens significantly improve parameters of microcirculation.     

Relation Between Low Dose of Hydrochlorothiazide, Antihypertensive Effect and Adverse Effects

Thiazide diuretics are widely used in the drug treatment of hypertension but their dose-response curves for the antihypertensive and adverse metabolic effects differ. To characterize the lower end of the dose-response curve a double-blind, parallel group trial was performed as multicentre study in Scandinavia. One hundred and eleven patients with newly diagnosed or previously treated mild to moderate hypertension (untreated diastolic blood pressure of 95-115 mmHg after 4 weeks placebo) were randomly allocated to various doses of hydrochlorothiazide (3, 6, 12.5 or 25 mg) or placebo for 6 weeks. Blood pressure and biochemical variables (plasma renin activity, serum potassium, magnesium, urate, fasting glucose, total cholesterol, HDL-cholesterol, triglycerides and apolipoproteins A1 and B were measured. 12.5 mg hydrochlorothiazide had a borderline effect on blood pressure whilst 25 mg had a definite antihypertensive effect. Biochemical changes were seen in plasma renin activity, serum potassium and urate after the 12.5 and 25 mg dose. Three and 6 mg had no effect on blood pressure or metabolic parameters.     

卡托普利与小剂量氢氯噻嗪合用治疗高血压疗效观察

目的：研究卡托普利与小剂量氢氯噻嗪合用对高血压患者的疗效及对代谢的影响。方法：５０例原发性高血压患者随机分为两组,第１组：单用卡手早１２．５ｍｇ～７５ｍｇ,每日２～３次。第２组,卡手早１２．５ｍｇ,每日２次,加服氢氯噻嗪１２．５ｍｇ,每日１次,两组治疗时间均为８周,测定治疗前后的基础血压,空腹血糖、血脂、血、血 到、 纱氮、肌酐以及有后的２４小时动态血压。 托普利加小剂量氢氯噻嗪组的总有效率及２４     

Enalapril in the treatment of essential arterial hypertension

This study evaluates the antihypertensive effects of enalapril, a new, potent, long acting angiotensin converting enzyme inhibitor. 69 patients with uncomplicated essential hypertension were included in 5 groups. Group I was used to compare the effects of enalapril and propranolol on blood pressure, renal function, plasma renin activity, aldosterone excretion and plasma lipids in 24 patients after 12 weeks. Group II was used to evaluate long term effects (48 weeks) of these drugs in 13 patients. Group III included 32 patients that received enalapril as monotherapy for 6 to 12 weeks. Group IV was studied to estimate the antihypertensive effect of low doses of hydrochlorothiazide in 18 patients receiving enalapril. Group V was used to compare the antihypertensive effect of hydrochlorothiazide, enalapril or enalapril plus hydrochlorothiazide in 19 patients. The effect on mean blood pressure was similar with enalapril and propranolol (117 versus 103 mmHg and 115 versus 104 mmHg respectively); however, glomerular filtration rate decreased with propranolol (105 versus 87 ml/min; p less than .05) and was unaltered with enalapril (102 versus 98 ml/min). Triglycerides rose with propranolol (179 versus 231 mg/dl; p less than .05) and did not change with enalapril (157 versus 121 mg/dl). In the long term, antihypertensive effects were similar and no significant side effects were observed. In 14/32 patients blood pressure became normal with enalapril alone. Low doses of hydrochlorothiazide (12.5 to 25 mg) decreased mean blood pressure by 10 mmHg when added to enalapril. The antihypertensive effect of enalapril plus hydrochlorothiazide was significant greater than that of enalapril or hydrochlorothiazide alone. Used as monotherapy, enalapril normalised blood pressure in 44% of cases. Addition of low doses of hydrochlorothiazide significantly increased the antihypertensive effect of enalapril. These results show that enalapril is a good antihypertensive agent alone or with low doses of diuretic.     

Potassium restoration in hypertensive patients made hypokalemic by hydrochlorothiazide

Among 447 hypertensive patients, most with a history of diuretic-induced hypokalemia, 252 developed diuretic-induced hypokalemia while receiving hydrochlorothiazide, 50 mg/d. In a randomized study we evaluated the efficacy of three drug regimens in restoring potassium levels while maintaining blood pressure control: hydrochlorothiazide (50 mg/d) plus potassium supplement (20 mmol/d); hydrochlorothiazide (50 mg/d) plus potassium supplement (40 mmol/d); or hydrochlorothiazide (50 mg/d) with triamterene (75 mg/d) in one combination tablet. In all groups, mean serum levels of potassium rose within 1 week and showed no further change thereafter. However, the hydrochlorothiazide/triamterene and hydrochlorothiazide plus 40 mmol of potassium regimens were significantly more effective in restoring serum potassium levels than was the hydrochlorothiazide plus 20 mmol of potassium regimen. A significant increase in magnesium levels was observed only in the group treated with the hydrochlorothiazide/triamterene combination. Each regimen provided continued control of mild to moderate hypertension.     

The efficacy and tolerability of long-term felodipine treatment in hypertension

Summary The antihypertensive effect of felodipine and hydrochlorothiazide, both given in addition to beta-blockers, were compared in this double-blind multicenter study in 103 patients. To all patients concluding the study (n=92), felodipine was given openly, and the antihypertensive effect and tolerability was studied for 1 year. Patients with a diastolic blood pressure 100 mmHg, despite beta-blocker treatment, were randomized to treatment with felodipine 5 mg twice daily (n=51) or hydrochlorothiazide 25 mg (n=52) once daily for 4 weeks. The dose was then doubled in all patients for a second 4-week period. During open follow-up, all patients were given felodipine 5–15 mg (starting dose 5 mg) twice daily in addition to the beta-blocker. Hydrochlorothiazide could also be added. Reductions in systolic and diastolic blood pressure were significantly greater with felodipine than with hydrochlorothiazide at both the low and high dose levels. There were significantly more responders (diastolic blood pressure 90 mmHg or fall of 10 mmHg) in the felodipine group. Felodipine and hydrochlorothiazide were both well tolerated. Hydrochlorothiazide treatment was accompanied by a decrease in serum potassium and an increase in serum uric acid. One year of treatment felodipine therapy resulted in a blood pressure fall from baseline of 34/23 mmHg. The most commonly reported adverse event was ankle edema. No clinically important changes in blood tests were seen during felodipine treatment. In conclusion, felodipine was more effective in reducing elevated blood pressure than hydrochlorothiazide, when both were given in addition to a beta-blocker. A substantial blood pressure reduction was seen during long-term treatment with felodipine.