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。     

厄贝沙坦氢氯噻嗪治疗轻中度原发性高血压疗效观察

目的:观察厄贝沙坦氢氯噻嗪(厄贝沙坦150 mg/氢氯噻嗪12.5 mg复方制剂)治疗单用厄贝沙坦150 mg控制不良的轻中度高血压患者的疗效和安全性.方法:经厄贝沙坦150 mg 1次/日治疗4周,血压仍未正常(收缩压≥145 mmhg,舒张压≥95mmhg)的99例高血压患者随机分为两组,治疗组给于厄贝沙坦氢氯噻嗪1片,1次/日,对照组继续服用厄贝沙坦150 mg,1次/日,疗程8周.在治疗4周和结束时评估药物的安全性和有效性.结果:在轻中度高血压患者中厄贝沙坦氢氯噻嗪1片,天比单用厄贝沙坦150 mg/天血压下降达标率高.治疗结束时平均坐位收缩压降低4 mmHg,平均坐位舒张压下降2.5mmhg,血压控制<140/90mmHg的患者在厄贝沙坦氢氯噻嗪1片/天组和单用厄贝沙坦150 mg/天组分别为53.9%和40.9%.结论:轻中度原发性高血压患者采用厄贝沙坦氢氯噻嗪1片/天降压有效率及达标率优于厄贝沙坦150 mg/天组.厄贝沙坦氢氯噻嗪适用于厄贝沙坦单药控制不良的轻中度原发性高血压患者.     

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。     

坎地沙坦酯与依那普利治疗原发性高血压

目的比较观察国产坎地沙坦酯（迪之雅）与依那普利治疗轻中度原发性高血压的临床疗效及安全性。方法采取随机开发对照试验。56例轻中度原发性高血压患者,随机分为坎地沙坦酯组（治疗组）和依那普利组（对照组）各28例。分别给予国产坎地沙坦酯（迪之雅8mg/片）片8mg/d,依那普利10mg/d。用药2周后血压未降至目标水平（〈140/90mmHg）者剂量加倍,至8周治疗结束。结果两组药物均有显著降压疗效。治疗组有效率89.3%,对照组85.7%,两组有效率比较无显著性差异。对照组发生干咳者4例,发生率为14.3%;而治疗组无一例发生。结论观察结果证实国产坎地沙坦酯（迪之雅）和依那普利治疗轻中度原发性高血压均有确切疗效,有效率相似,一般副作用轻微。但坎地沙坦酯很少发生干咳,具有更好的耐受性。     

坎地沙坦酯与氯沙坦治疗轻中度高血压病的比较

目的 比较坎地沙坦酯与氯沙坦治疗轻中度高血压病患者的降压疗效.方法 采用随机、双盲研究方法.经2周的单盲、安慰剂导入期,72例坐位舒张压在95～115 mm Hg之间的高血压患者被随机分入坎地沙坦酯4mg/d(n=36)或氯沙坦50mg/d(n=36).4周末.如坐位舒张压仍≥95 mm Hg,每日剂量加倍(坎地沙坦酯8mg/d或氯沙坦100mg/d),总疗程8周.结果 两组患者服药后血压均显著降低(P＜0.01).经8周治疗,坎地沙坦酯组平均坐位收缩压与舒张压分别降低15.0%与13.7%,在氯沙坦组分别为13.7%与14.0%.两药的有效率无显著性差异(坎地沙坦酯组75.0%,氯沙坦组71.4%,P＞0.05).与坎地沙坦酯组不同,氯沙坦组血尿酸水平显著降低.结论 在轻中度高血压的治疗中,坎地沙坦与氯沙坦同样有效和安全.     

国产坎地沙坦酯治疗原发性高血压临床疗效观察

目的本观察旨在评价国产坎地沙坦酯（维尔亚）治疗轻中度高血压的临床疗效及安全性。方法入选Ⅰ、Ⅱ级原发性高血压患者,共62例。其中Ⅰ级高血压25例,Ⅱ级高血压37例。服用国产坎地沙坦酯片一日1次,4mg,如2周后血压未降至目标水平（140mmHg／90mmHg以下）者将剂量增加为一日8mg,连续治疗4周。4周后血压未降至目标水平者加用噻嗪类利尿剂,直至血压控制平稳。结果62例入选患者服药（一日4mg）一周后20例血压即有明显下降,继续服药有进一步下降趋势。42例下降不明显者中33例加量（8mg）后血压有明显下降。9例继续服药2周后血压仍下降不明显,改用其他降压药,作无效处理。用药4周后显效31例（50％）,有效22例（35％）,无效9例（15％）,总有效率为85％。用药4周后血压下降达标到目标水平37例,达标率为60％。服药后不良反应发生率很低。结论本观察结果证实国产坎地沙坦酯（维尔亚）治疗原发性高血压,疗效确切,不良反应少,耐受性好,值得临床推广。     

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。     

奥美沙坦酯片治疗轻中度原发性高血压的疗效和安全性

目的评价国产奥美沙坦酯片治疗轻中度原发性高血压的疗效和安全性。方法用随机双盲双模拟多中心活性药对照的试验设计,符合入选条件的221例轻中度原发性高血压患者随机分为奥美沙坦酯组和氯沙坦组,治疗8周,观察2组治疗前后的血压、心率、心电图和血尿实验室检查的变化。动态血压用开放试验方法,分别在安慰剂末期和治疗期结束时(未停药),做24h动态血压监测。结果奥美沙坦组与氯沙坦组比较,平均坐位收缩压和舒张压降低程度都有显著性差异,分别为17.22vs11.02mmHg,(P<0.01);13.41vs11.18mmHg(P<0.05)。奥美沙坦组降压总有效率为82.41%;每日1次服用奥美沙坦酯片作用可持续24h,药物降低收缩压和舒张压的谷峰比值均>50%。2组药物不良反应发生率分别为3.5%,5.4%,2组比较无显著性差别。结论国产奥美沙坦酯片治疗轻中度原发性高血压患者,能24h平稳降压,谷峰比满意,且耐受性较好。     

坎地沙坦酯联合吲哒帕胺治疗轻中度原发性高血压的达标率分析

目的评价坎地沙坦酯联合小剂量吲哒帕胺治疗高血压的疗和达标率。方法采用自身对照开放单一治疗试验研究。入选64例轻中度原发性高血压患者。均采用口服坎地沙坦酯4mg／d及小剂量吲哒帕胺1.25mg/d治疗8周,观察其降压疗效及达标率。结果治疗8周后,总有效率为92.18％,舒张压〈90mm Hg的达标率为90.62％,舒张压〈85mm Hg的达标率为79.68％。未观察到严重的不良反应,治疗前血清钾为（4.23±0.37）mmol／L,治疗后下降为（4.12±0.41）mmol／L,但无统计学意义。结论坎地沙坦酯联合小剂量吲哒帕胺治疗轻中度原发性高血压患者的有效率和达标率均较高,不良反应少。     

坎地沙坦酯治疗轻中度高血压病人的疗效及安全性

目的：评价坎地沙坦酯治疗轻中度高血压病人的疗效及安全性。方法：人选48例轻中度高血压病人，经2周导人期后随机分人试验组和对照组各24例，按双盲、平行临床药理试验方法分别给予坎地沙坦酯8mg和氯沙坦50mg治疗。治疗4周后如不能有效控制血压，则将用药剂量加倍并维持到第8周末。检测病人治疗前、后不同时间的血压，心率，以及血、尿常规，肝、肾功能，并记录服药期间可能发生的不良事件。结果：试验组和对照组降压显效率均为100％，治疗后2周末收缩压(SBP)和舒张压(DBP)均已明显降低。此后血压继续下降，与治疗前相比，用药8周末试验组和对照组SBP分别下降20．3和16．4mmHg，DBP分别下降16．8和16．1mmHg。试验组中有1例病人服药期间出现头痛，1例病人感轻微胸闷和腹胀。两组病人血、尿常规，肝、肾功能均正常。结论：坎地沙坦酯治疗轻中度高血压病人降压效果良好，服用安全。     

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     

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。     

Antihypertensive treatment in elderly patients aged 75 years or over: a 24-week study of the tolerability of candesartan cilexetil in relation to hydrochlorothiazide

OBJECTIVE: To assess the safety and tolerability of the AT1-receptor blocker candesartan cilexetil in relation to the diuretic hydrochlorothiazide (HCTZ) in elderly patients. DESIGN AND SETTING: A multicentre, double-blind, randomised, parallel group study. 32 general practice centres and 3 hospital centres in Denmark and Finland participated in this study. Patients: 185 patients aged > or =75 years with mean sitting diastolic blood pressure (DBP) of 95 to 114mm Hg. INTERVENTIONS: After a placebo run-in period of 4 to 8 weeks, patients were randomised to once daily treatment with candesartan cilexetil 8mg or HCTZ 12.5mg for 24 weeks. In both treatment groups the dosage could be doubled after > or =2 weeks [according to blood pressure (BP) response] and, if necessary, subsequently decreased if the higher dosage was poorly tolerated. MAIN OUTCOME MEASURES: Proportion of patients with at least 1 adverse event; changes in laboratory values, electrocardiogram and BP during the double-blind treatment period. RESULTS: Once daily candesartan cilexetil 8 to 16mg was very well tolerated. The most common adverse events in both treatment groups were dizziness or vertigo and headache. Although the profile of adverse events was generally similar in the 2 treatment groups, it was notable that hypokalaemia and hyperuricaemia were not found in patients treated with candesartan cilexetil but occurred in 8.1 and 6.5%, respectively, of patients treated with HCTZ. At week 24, the adjusted mean changes in sitting DBP (24 hours postdose) from baseline were -12.0mm Hg [95% confidence interval (CI) -1 0.4 to -13.6] in patients treated with candesartan cilexetil and -11.4mm Hg (95% CI -9.3 to -13.6) in patients treated with HCTZ. The difference between treatments in favour of candesartan cilexetil was not statistically significant. CONCLUSIONS: This study shows that antihypertensive treatment with candesartan cilexetil in elderly patients (aged > or =75 years) is well tolerated with a good safety profile and avoids the metabolic adverse effects of diuretic therapy.     

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.     

与氯少坦对照评价坎地沙坦西酯治疗轻 中度高血压的疗效和安全性

目的评价坎地沙坦西酯对轻、中度原发性高血压的降压疗效及安全性。方法采用随机双盲研究方法,坎地沙坦西酯和氯沙坦随机、双盲治疗轻、中度原发性高血压患者40例,男性30例,女性10例,年龄(46±6)岁,各组20例,给予双盲药坎地沙坦西酯8mg口服,每日1次,或氯沙坦50mg口服,每日1次;4周后根据血压情况决定维持原剂量或分别增加到12mg口服,每日1次,或100mg口服,每日1次;总疗程8周。结果坎地沙坦西酯治疗原发性轻、中度高血压8周末的显效率55%,总有效率75%,收缩压下降(20.0±12.5)mmHg,下降幅度为15.2%;舒张压下降(10.0±2.4)mmHg,下降幅度为10.8%,出现不良反应的发生率为5%。结论坎地沙坦西酯治疗轻、中度原发性高血压的短期疗效明显,每日1次,疗效持久稳定,不良反应少。     

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   

厄贝沙坦片联合氢氯噻嗪片治疗92例轻中度高血压的临床分析

目的探讨氢氯噻嗪片联合厄贝沙坦片治疗轻中度高血压的临床疗效。方法选择2010年6月至2011年6月已确诊的轻中度原发性高血压患者184例,随机分为观察组和对照组各92例,对照组予以口服厄贝沙坦片150mg,1次/d,观察组在对照组治疗基础上加服氢氯噻嗪片12.5mg,1次/d,总疗程8周。于治疗前与治疗8周末进行心电图、血尿常规、血生化、电解质、尿酸等检查。每2周随访坐位血压、心率1次。结果观察组总有效率91.30%,对照组总有效率73.91%,两组差异有统计学意义(P<0.01);两组SBP和DBP均下降,且治疗组的收缩压和舒张压下降均较对照组更明显,两组差异显著具有统计学意义(P<0.001)。两组均无因严重不良反应。结论厄贝沙坦片和氢氯噻嗪片二者联合对轻中度高血压患者降压效果更显著,对代谢影响不明显,不良反应小,值得临床推广。