培哚普利治疗原发性高血压的临床观察

目的观察培哚普利对原发性高血压的降压作用及副反应。方法３７例轻中度原发性高血压患者予培哚普利共８周，评价对随诊血压及２４ｈ动态血压的影响。结果治疗４周收缩压（ＳＢＰ）无明显降低（Ｐ＞０．０５），舒张压（ＤＢＰ）明显降低（Ｐ＜０．００１），８周ＳＢＰ、ＤＢＰ均明显降低（Ｐ＜０．００１），随诊血压降压有效率分别为５４．１％（４周）及６７．６％（８周），２４ｈ动态血压曲线８周时呈明显下降，除咳嗽外未发现其他严重副反应。结论培哚普利对轻中度原发性高血压是安全有效的降压药物。     

培哚普利与卡托普利对高血压的疗效比较

评价培哚普利治疗中度原发性高血压的有效性和安全性并与卡托普利比较。１２０例患者随机分为培哚普利组和卡托普利组，每组中４４例行偶测血压监测，１６例行动态血压监测；培为利４－６ｍｇ，１／ｄ，卡托普利１２．５－１８．７５ｍｇ，３／ｄ，疗程４周。降压总有效率培哚普利组为９１．７％，卡托普利组为７８．３％；副作用发生率培哚普利组为１１．７％，且均较轻微。     

培哚普利与苯磺酸氨氯地平联合治疗原发性高血压的疗效观察

目的探讨培哚普利与苯磺酸氨氯地平联合治疗原发性高血压的疗效。方法将80例原发性高血压患者随机分为治疗组和对照组,治疗组40例在应用培哚普利的基础上加用苯磺酸氨氯地平片,对照组40例采用培哚普利,观察两组药物对高血压的疗效。结果治疗组总有效率90.0%,对照组总有效率77.5%,两组比较差异有统计学意义(P0.05)。结论培哚普利与苯磺酸氨氯地平联合治疗高血压疗效肯定、不良反应少,值得推广。     

培哚普利与卡托普利治疗老年原发性高血压的疗效比较

目的：比较培哚普利与卡托普利对老年原发性高血压的降压效应与安全性。方法：６０例老年原发性高血压患者随机分组接受培哚普利（４～８ｍｇ／ｄ）和卡托普利（３７．５～７５．０ｍｇ／ｄ）（各３０例）治疗４周。结果：培哚普利和卡托普利的降压总有效率偶测血压分别为９０．０％和８６．７％（Ｐ＞０．０５），动态血压监测分别为９５．０％和６５．０％（Ｐ＜０．０５）。结论：培哚普利治疗老年原发性高血压有效而安全，降低夜间舒张压优于卡托普利。     

培哚普利治疗原发性高血压合并2型糖尿病的临床观察

目的观察培哚普利治疗原发性高血压合并2型糖尿病的疗效及安全性。方法将112例临床确诊的原发性高血压患者分为两组,55例原发性高血压合并2型糖尿病为A组,57例单纯原发性高血压为B组,均给予培哚普利治疗,2、4、6周末测血压,治疗前及治疗6周后监测肝肾功能、电解质、心电图、血脂及血糖。结果6周后A组显效率47．2％,总有效率79．3％,B组显效率50．9％,总有效率78．9％,组间比较差异无统计学意义（P〉0．05）;2、4、6周末两组血压均较治疗前显著降低（P〈0．05）,组间比较差异无统计学意义（P〉0．05）;6周末与治疗前比较,肝肾功能、电解质、心电图、血脂及血糖无明显变化（P〉0．05）,不良反应A组9．1％,B组7．2％。结论培哚普利治疗原发性高血压合并2型糖尿病降压疗效好且安全。     

培哚普利治疗老年隐匿性高血压的临床观察

目的 探讨培哚普利对老年隐匿性高血压(MH)患者的影响.方法 诊室血压正常而24 h动态血压监测(ABPM)异常的老年MH患者66例,分为治疗组36例,服用培哚普利2～4 mg/d,平均10.5月后复查ABPM;对照组30例同期作ABPM,比较参数.结果 对照组ABPM参数观察期前后无显著性差异.治疗组24 h平均收缩压(24h-SBP)、昼间平均收缩压(dSBP)、24 h平均舒张压(24h-DBP)、昼间脉压差(dPP)、夜间平均收缩压(nSBP)、24 h收缩压标准差(24h-SBPSD)、24 h收缩压变异系数(24h-SBPCV)治疗前后均有显著性差异(P＜0.05或P＜0.01).结论 培哚普利可有效降低老年MH患者血压,改善昼夜节律和血管顺应性,有利于改善预后.     

应用两种血压测量方法指导培哚普利抗高血压治疗的比较-中国APTH研究（中国动态血压监测与高血压治疗研究）

目的　探讨应用动态血压监测 (ABPM)指导抗高血压治疗是否优于诊室血压 (CBP)。方法　采用随机双盲设计 ,经安慰剂洗脱 ,若CBP的舒张压 (DBP)为 95～ 114mmHg便可随机进入ABP组和CBP组 ,两组均测ABP与CBP ,但ABP组根据ABP血压值调整降压药 ,目标血压为白昼平均血压DBP 80～ 89mmHg ;CBP组为DBP 80～ 89mmHg。全部病人同时口服ACEI制剂培哚普利每日 2～ 8mg,疗程六个月。 结果　两组病人血压都有不同程度的下降 ,CBP下降幅度CBP组大于ABP组 (17 3/ 11 7:15 5 / 12 2mmHg,P >0 0 5 )。ABPM各时间段血压下降幅度ABP组均大于CBP组 ,白昼平均血压下降ABP组为 14 2 / 8 1,CBP组为 13 8/ 7 2mmHg ,两组间无显著差异 ;ABP组服用培哚普利 4mg的病人数多于CBP组 (P =0 0 4 ) ,药物副作用ABP组低于CBP组。结论　应用ABPM指导抗高血压治疗较CBP更科学合理。     

培哚普利治疗冠心病42例疗效观察

目的探讨培哚普利治疗冠心病的有效性和安全性。方法入选符合我国冠心病诊断标准的病例42例。所有病人服用培哚普利(商品名:雅施达)4mg,每日1次,共6个月。结果治疗前后动态血压监测(ABPM)结果显示,全天收缩压和舒张压、日间收缩压和舒张压、夜间收缩压和舒张压均较治疗前有所下降(P<0.05)。平板运动试验结果显示,治疗后运动试验持续时间较治疗前延长;至发生ST段下移1mm的时间较治疗前延长(P<0.01)。治疗6个月后,平均每周心绞痛发作次数及硝酸甘油用量均较前治疗减少。病人治疗前后各项实验室检查均未见明显变化,未发现心肌梗死及心血管病死亡事件。结论培哚普利用于冠心病的二级预防安全有效,病人依从性好。     

非洛地平缓释片,比索洛尔和培哚普利对原发性高血压患者24小时血？…

目的：比较非洛地平缓释片、比索洛尔和培哚普利对４８例原发性高血压患的降压疗效。方法：采用随机,单盲和平行对照的方法,运用２４小时动态血压监测之。结果：３种药均能显降低血压,彼此间降低偶测血压的幅度无显差异,非洛地平缓释片和比索洛尔降低２４小时平均和白天平均血压的幅度大于培哚普利。３种药均能有效控制清晨高峰期的血压,它们的降压谷／峰比值都超过６５％。结论：非洛地平缓释片、比索洛尔和培哚普利均可     

24小时动态血压监测培哚普利降压效果

目的 :评价 2 4h动态血压监测 ( ABPM)培哚普利降压效果。方法 :选择轻、中度原发性高血压患者 48例 ,给予培哚普利 4mg,qd于早晨 8:0 0口服 ,共 4周。ABPM用药前后 2 4h血压变化情况。结果 :培哚普利治疗后 2 4h血压显著下降 ( P <0 .0 5 ) ,降低舒张压优于收缩压 ,总有效率为 81.2 %。白天与夜间血压下降幅度大致相等 ,仍保持正常血压昼夜节律变化。结论 :培哚普利是治疗轻、中度原发性高血压较为理想的第一线药物     

盐酸阿罗洛尔治疗杓型及非杓型原发性高血压的临床研究

目的观察盐酸阿罗洛尔对杓型及非杓型原发性高血压患者的24 h动态血压的影响.方法选择符合入选条件的1～2级原发性高血压患者47例.平均年龄(49.6±7.8)岁(18～70岁).服用安慰剂1周后,测量24 h动态血压,根据夜间血压下降程度将患者分为杓型组和非杓型组,其中杓型组23例,非杓型组24例.所有患者给予盐酸阿罗洛尔治疗,每次10～15mg,2次/d,连续4～6周,治疗结束时再测量一次24h动态血压.结果治疗4周后两组偶测血压均较治疗前有显著降低,杓型组的治疗总有效率为78.2%,非杓型组为54.2%;动态血压各项指标:24 h平均收缩压(24hMSBP)、24 h平均舒张压(24hMDBP),白天平均收缩压(dMSBP)、白天平均舒张压(dMDBP)和血压负荷均有显著降低,同时全天的心率也较治疗前明显下降;治疗后,非杓型组24例患者中,有12例(50%)血压节律改变为杓型.结论盐酸阿罗洛尔是一种有效的抗高血压药物,在影响血压节律方面,能够更显著地降低非杓型患者的夜间血压水平.     

氨氯地平和培哚普利联合治疗对高血压病患者肾功能的影响

探讨氨氯地平，培哚普利单独治疗和联合治疗对高血压病患者肾功能的影响。方法 ６６例高血压病患者随机分为三组：氨氯地平组；培哚普利组；氨氯地平和培哚普利联合治疗组。疗程２４周，治疗前后观察肾功能指标变化。结果 １．氨氯地平，培哚普利及联合治疗组高血压病患者治疗后均能显著降低血压及尿蛋白排泄量「２４小时尿白蛋白：１０２±３６．４．１０４．７±４２．７和１０１．４±０．０６５，０．２４±０．６２及０．２３     

Racial variation in cardiovascular morbidity and mortality in essential hypertension

OBJECTIVES: To perform a longitudinal comparison of morbidity and mortality among white, south Asian and Afro-Caribbean hypertensive patients in relation to baseline demographic characteristics and clinic and ambulatory blood pressure variables. DESIGN: Observational follow up study. SETTING: District general hospital and community setting in Harrow, England. PATIENTS: 528 white, 106 south Asian, and 54 Afro-Caribbean subjects with essential hypertension who had undergone 24 hour ambulatory intra-arterial blood pressure monitoring. INTERVENTIONS: Follow up for assessment of all cause morbidity and mortality over a mean (SD) of 9.2 (4.1) years. MAIN OUTCOME MEASURES: Non-cardiovascular death, coronary death, cerebrovascular death, peripheral vascular death, non-fatal myocardial infarction, non-fatal stroke, coronary revascularisation. RESULTS: South Asians had the highest all cause event rate of 3.46, compared with 2.50 (NS) and 0.90 (p = 0.002) events/100 patient-years for whites and Afro-Caribbeans, respectively. This was because of an excess of coronary events (2.86 v 1.32 events/100 patient-years in south Asians v whites, respectively; p = 0.002). Age (p < 0.001), sex (p < 0.001), race (south Asians : whites, hazard ratio 1.79; p = 0.008), diabetes (p = 0.05), previous history of cardiovascular disease (p < 0.001), and 24 hour ambulatory systolic blood pressure (p = 0.006) were independent predictors of time to a first event. Clinic blood pressure did not provide additional prognostic information. CONCLUSIONS: South Asian origin was an independent predictor of all cause events, mainly because of an excess of coronary events in this group. Ambulatory but not clinic blood pressure was of additional value in predicting subsequent morbidity and mortality.     

The relationship between casual and ambulatory blood pressure in essential hypertension: the influence of work, duration of hypertension and antihypertensive treatment

Casual blood pressure (BP) and ambulatory BP (mean 24-h BP) were determined in 23 untreated patients with essential hypertension and in 11 normotensive healthy control subjects. Mean 24-h BP was significantly lower than casual BP in patients with essential hypertension, but not in control subjects. This was demonstrated in the patients who did not work during the ambulatory BP monitoring and in the patients with newly recognized hypertension, whereas no differences were revealed either in the patients who went to work or had a known duration of hypertension longer than 6 months. The size of the difference between casual BP and mean 24-h BP was unaffected by antihypertensive therapy with metoprolol and also individually reproducible. An accordance between casual and ambulatory BP measurements in evaluation of the efficacy of antihypertensive treatment was found in 75% of the patients. Casual BP and mean 24-h BP were weakly correlated both before and during antihypertensive treatment. It is concluded that the higher casual BP than ambulatory BP in essential hypertension may be a specific characteristic of the disease. Both work and known duration of hypertension longer than 6 months eliminate the difference between casual ambulatory BP in essential hypertension. Ambulatory BP monitoring seems to be superior to casual BP measurements in the evaluation of antihypertensive treatment.     

老年男性高血压患者脉压指数特征的分析

目的分析老年男性高血压患者脉压指数特征及其对心脑血管事件危险性的预测价值。方法选择265例老年男性高血压患者进行动态血压监测,按脉压指数水平分层:≤0.400(103例),0.401～0.500(124例),≥0.501(38例),分析高血压患者昼夜及不同脉压指数的动态血压特征及心脑血管事件危险性。结果高血压患者夜间脉压较昼间明显降低(P<0.01);脉压指数昼夜变化幅度较小,差异无统计学意义(P>0.05)。随脉压指数增加,高血压患者平均收缩压(24 h、昼间、夜间)、平均脉压(24 h、昼间、夜间)、收缩压最高值、收缩压变异性(24 h、昼间)、夜间收缩压负荷值明显升高;而平均舒张压(24 h、昼间、夜间)、舒张压最低值、昼间舒张压负荷值、夜间血压下降率均明显下降(P<0.01)。随脉压指数增加,心脑血管事件发生率增高(P<0.01)。结论脉压指数较脉压更有利于对患者动脉硬化做出准确评估,且对老年男性高血压患者心脑血管事件危险性有一定预测价值。     

动态脉压与老年高血压合并冠心病及颈动脉硬化的关系

目的研究老年高血压患者动态脉压(PP)与冠心病并发症及颈动脉粥样硬化的关系,为临床有针对性的干预PP、预防高血压并发症提供理论基础。方法对老年高血压及老年高血压合并冠心病的动态PP进行比较,同时对老年高血压颈动脉内膜中层厚度(IMT)增厚组与正常组的动态PP进行比较。结果(1)与单纯高血压组比较,高血压合并冠心病组的24h动态脉压(24hAPP)、白昼脉压(dPP)、夜间脉压(nPP)水平显著增大,24h平均收缩压(24hASBP)、夜间平均收缩压(nSBP)水平显著升高,24h平均舒张压(24hADBP)、白昼平均舒张压(dDBP)、夜间平均舒张压(nDBP)水平显著下降,而2组间dSBP比较无统计学意义;(2)老年高血压患者IMT增厚组的24hAPP、dPP和nPP水平均显著高于IMT正常组;(3)与动态PP<60mmHg者比较,动态PP≥60mmHg的高血压患者冠心病发生率显著升高;(4)与动态PP<60mmHg者比较,动态PP≥60mmHg的单纯高血压患者的IMT显著增厚。结论动态PP增大是老年高血压患者颈动脉粥样硬化及未来发生冠心病的重要危险因素。     

24-hour efficacy of once-daily diltiazem in essential hypertension.

The safety and effectiveness of a once daily formulation of diltiazem hydrochloride (diltiazem CD) in the treatment of essential hypertension was assessed in a total of 127 patients with supine diastolic blood pressures (DBP) of 95 to 110 mmHg randomized to diltiazem CD (n = 61) or placebo (n = 66). Patients were titrated to doses of 120, 240, or 360 mg to achieve DBP reduction to less than 90 mmHg. At end study diltiazem CD changed trough supine SBP and DBP by -8.4 +/- 1.7 (p = 0.0009) and -8.6 +/- 1.1 mmHg (p = 0.0075), respectively. Heart rate was not significantly changed (-1.3 +/- 1.1 beats/min, p = 0.4362). The average dose of diltiazem CD was 268 mg with 69% achieving a clinical response. A subset of 47 patients underwent ambulatory blood pressure monitoring to assess the consistency of the effect over the full 24-h dosing interval. Diltiazem CD lowered DBP and SBP throughout the dosing interval. The overall side effect profile was similar to placebo. This study provides evidence of 24-h efficacy of this new, once daily formulation of diltiazem.     

马尼地平治疗轻中度高血压患者的疗效观察

目的评价盐酸马尼地平治疗原发性轻中度高血压患者的降压疗效。方法选择门诊原发性轻中度高血压患者180例,随机分为试验组(90例)和对照组(90例),试验组给予盐酸马尼地平和苯磺酸氨氯地平模拟剂,对照组给予苯磺酸氨氯地平和盐酸马尼地平模拟剂,比较2组患者基线和治疗期末的血压和心率。2组患者中各选择24例在双盲治疗期开始和结束时进行24 h动态血压监测,比较2组24h、昼间、夜间血压平均值和谷峰比值及平滑指数。结果试验组与对照组治疗期末舒张压和收缩压下降值比较,差异无统计学意义(P>0.05);与基线比较,2组治疗期末收缩压和舒张压明显降低(P<0.01)。24 h动态血压监测分析,2组间治疗期末24 h、昼间及夜间收缩压和舒张压下降值差异无统计学意义(P>0).05);与基线比较,试验组和对照组治疗期末收缩压和舒张压明显降低(P<0.05,P<0.01);试验组谷峰比值较对照组明显降低(P<0.05),而平滑指数和不良反应发生率差异无统计学意义(P>0.05)。结论盐酸马尼地平治疗原发性轻中度高血压患者疗效可靠,不良反应较轻。     

老年原发性高血压患者血压晨峰现象对靶器官影响的临床研究

目的研究老年原发性高血压患者血压晨峰现象，明确其对主要靶器官结构及功能的潜在损害。方法采用24h动态血压监测仪分析88例老年高血压患者的血压，确认晨峰组与非晨峰组，均常规检查血脂、空腹血糖、测定尿微量白蛋白（UALB），计算体质量指数（BMI）、左心室质量指数（LVMI）、心电图计算QT离散度（QTcd）。结果晨峰组的24h白昼、夜间平均收缩压均显著高于非晨峰组动态血压监测水平，晨峰组的LVMI、QTcd和UALB指标均高于非晨峰组（P〈0．05）；2组BMI、血脂、血糖差异无统计学意义（P〉0．05）。结论血压晨峰使靶器官损害增加，因此遏制原发性高血压患者的晨峰反应对降压达标和减缓靶器官受累程度具有重要意义。