Left ventricular changes after chronic therapy with enalapril maleate in moderate to severe hypertensive patients

Summary

A randomized double-blind trial was carried out to determine the relationship of the changes in blood pressure and heart rate with changes in echocardiographic left ventricular indices in moderate to severe hypertensive patients with established left ventricular hypertrophy who were being treated chronically with enalapril or hydrochlorothiazide plus propranolol for 26 weeks. After a 2-week period on placebo, drug dosages in the two groups were adjusted to individual needs until blood pressure was normalized (diastolic <90 mmHg). Patients in Group I received 10 to 40?mg enalapril/day; those in Group II received 50?mg hydrochlorothiazide plus 80 to 240?mg propranolol/day. Echocardiographic measurements were made at the end of the placebo and 26-week active treatment periods. Significant correlations were observed between the changes in four pairs of variables in each group. In the 8 patients receiving enalapril, there were negative correlations between interventricular septal thickness and supine systolic blood pressure, erect and supine heart rates, and a positive correlation between relative wall thickness and erect diastolic blood pressure. In the 7 patients on hydrochlorothiazide plus propranolol, there were negative correlations between relative wall thickness and erect and supine heart rate, and positive correlations between left ventricular mass and erect diastolic blood pressure, and the percentage change in internal diameter of the left ventricle and supine systolic blood pressure. Possible explanations for and implications of these regional changes are discussed.     

The efficacy and acceptability of the combination of acebutolol and hydrochlorothiazide in the treatment of essential hypertension

Summary

The efficacy and acceptability of a single half-tablet daily of a fixed combination of 400?mg acebutolol and 25?mg hydrochlorothiazide was assessed in a study of 35 patients suffering from mild to moderate essential hypertension. The results of the 22 patients who completed the 3-month active drug period showed that treatment produced a significant reduction in supine systolic and diastolic blood pressure. This effect was apparent from the first week and was maintained throughout the trial. Pulse rate was also lowered by therapy. No clinically significant changes from normal were observed in mean serum potassium and uric acid levels, and no side-effects of treatment were reported.     

贝那普利联用厄贝沙坦治疗射血分数正常心力衰竭的临床观察

目的 探讨贝那普利联用厄贝沙坦治疗射血分数正常心力衰竭(HFNEF)患者的安全性和有效性.方法 选取2014年2月至2015年11月本院确诊的HFNEF患者200例,随机分配至两组,治疗组(n=102例)给予贝那普利联用厄贝沙坦治疗,对照组(n=98例)给予贝那普利治疗.两组均进行为期6个月的治疗,比较两组患者6 min步行试验(6MWT)、心脏舒张功能超声多普勒指标[E/A比值、E/E’比值、左室侧壁E峰减速时间(DT)]以及N末端前脑钠肽(NT-proBNP)和血生化的变化.结果 联用治疗与贝那普利单用相比,6MWT距离增加,E/A、E/E’、DT改善,NT-proBNP降低更显著(P＜0.05).两组治疗方案间对血钾、肌酐的影响差异无统计学意义(P＞0.05).结论 贝那普利联用厄贝沙坦治疗HFNEF患者可产生更有益的疗效,且安全、耐受良好.     

厄贝沙坦氢氯噻嗪治疗轻中度高血压的疗效观察

目的观察厄贝沙坦氢氯噻嗪治疗轻中度原发性高血压的疗效及安全性。方法选取轻中度原发性高血压患者80例,随机分为两组,观察组(40例)服用厄贝沙坦氢氯噻嗪治疗,对照组(40例)服用厄贝沙坦治疗,4周后根据血压决定维持原剂量或原有剂量加倍;总疗程8周。结果观察组总有效率为97.5%,对照组总有效率为82.5%,两组比较差异有统计学意义(P<0.01),两组不良反应发生率均为5%。结论厄贝沙坦氢氯噻嗪治疗轻中度高血压疗效明显,不良反应发生率低。     

复方厄贝沙坦治疗原发性高血压疗效观察

目的研究和评价复方厄贝沙坦治疗原发性高血压的疗效和安全性。方法开放研究。选择30名轻中度高血压患者,复方厄贝沙坦(厄贝沙坦150mg/氢氯噻嗪12.5mg)口服,1/d,共8周,观察治疗前后的随测血压和生化指标。结果复方厄贝沙坦能够有效降低轻中度高血压患者的血压(治疗前后收缩压140.5±15.2mmHgvs124.6±8.0mmHg;舒张压93.1±7.3mmHgvs76.2±6.6mmHg,P<0.01),且治疗前后各项生化指标无明显变化。结论复方厄贝沙坦降压效果确切,同时不影响代谢,安全性好。     

厄贝沙坦与硝苯地平联用治疗原发性高血压50例临床观察

目的探讨厄贝沙坦与硝苯地平联用治疗原发性高血压的疗效。方法采取随机双盲对照法,将100例高血压病人随机分为两组。治疗组采用硝苯地平和厄贝沙坦,对照组采用硝苯地平和卡托普利,疗程1个月。观察治疗前后血压及肾功能恢复情况。结果治疗组降压总有效率86.0%,对照组总有效率78.0%,差别无统计学意义(P>0.05);治疗组肾功能恢复总有效率94.1%,对照组总有效率56.3%,差别有统计学意义(P<0.05)。结论厄贝沙坦联用硝苯地平治疗高血压的疗效,与卡托普利无差别,但对于高血压合并肾功能损害者疗效更好。     

Fixed combination of losartan and hydrochlorothiazide and reduction of risk of stroke

A fixed-dose combination of losartan/hydrochlorothiazide (HCTZ) therapy may be a logical choice for antihypertensive treatment, including for initial therapy in patients with blood pressure elevation >20/10 mmHg above treatment target. The renin-angiotensin-aldosterone-system-activating effect of hydrochlorothiazide augments the efficacy of blocking the angiotensin II type 1 (AT1) receptor with losartan. Some adverse effects associated with hydrochlorothiazide, including increased risk for new-onset diabetes mellitus, may be offset by losartan. Losartan was frequently administered with hydrochlorothiazide in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, in which there was a 25% risk reduction for stroke in the losartan-based compared with the atenolol-based treatment group. The efficacy, tolerability, and convenience of losartan/HCTZ combination therapy may increase patient compliance and lower risk for stroke, a devastating outcome in patients with hypertension.     

伊贝沙坦对血压正常的老年早期糖尿病肾病的干预作用

目的：通过检测24h微量白蛋白尿（MA）的变化，探讨伊贝沙坦对血压正常的老年早期糖尿病肾病患者肾脏保护的作用。方法：住院老年糖尿病患者（24h尿白蛋白排泄率20－200μg/min）48例，随机分为伊贝沙坦（Irb)组28例、安慰剂对照（C）组20例；二组患者空腹（FBG）和餐后2h血糖（2hBG)均控制在FBG≤7．0mmol/L、2hBG≤10.0mmol/L;IRB组给予伊贝沙坦75－150mg/d后第12wk、24wk检测血压、MA、肾功能和血清K^ 浓度，并与治疗前、C组同期进行比较。结果：治疗后第12wk和24wk检测血压、MA、肾功能和血清K^ 浓度，并与治疗前、C组同期进行比较。结果：治疗后第12wk和24wk，Irb组MA均较治疗前分别减少41．9％和48．3％（P均＜0．05）；而C组同期MA比治疗前增加2．5－7．8％，较之Irb组组间同期MA显著升高（P＜0．05）；各组治疗前、后患者的血压、肾功能和血清K^ 浓度均无显著变化；伊贝沙坦副作用轻微，无一例停药者。结论：伊贝沙坦可安全用于血压正常的老年早期DN患者，并可显著减少MA保护肾脏功能。     

厄贝沙坦联合胺碘酮治疗阵发性房颤的临床观察

目的探讨厄贝沙坦联合胺碘酮治疗阵发性房颤的临床效果及安全性。方法将我院阵发性房颤患者60例随机分为观察组和对照组,对照组给予胺碘酮治疗,观察组给予厄贝沙坦联合胺碘酮治疗,评估临床效果。结果治疗后观察组左房内径明显低于对照组,观察组左房内径明显低于治疗前,两者比较差异具有统计学意义（P〈0.05）。治疗后7d观察组转复窦性心律明显高于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后12个月观察组维持窦性心律明显高于对照组,两组比较差异具有统计学意义（P〈0.05）。两组均未出现明显的药物治疗副反应。结论厄贝沙坦联合胺碘酮治疗阵发性房颤效果好,副作用少,值得应用。