苯磺酸氨氯地平联合缬沙坦对高血压患者血压及蛋白尿的影响

目的研究苯磺酸氨氯地平联合缬沙坦对高血压患者血压和蛋白尿的影响。方法选择高血压并伴有蛋白尿检测阳性的患者90例,按照随机数表法分为A,B,C3组,各30例。A组患者采用苯磺酸氨氯地平治疗,B组患者采用缬沙坦治疗,C组采用苯磺酸氨氯地平联合缬沙坦治疗。对3组患者治疗前后血压、蛋白尿水平进行比较。蛋白尿的测定采用免疫比浊法。结果治疗8个月后,3组患者的收缩压和舒张压与治疗前相比均显著降低（P〈0．05）,c组患者降低幅度更明显（P〈0．05）;3组患者的蛋白尿水平与治疗前相比均显著降低（P〈0．05）,c组患者降低幅度更明显（P〈0．05）;在研究中还发现,血压的变化与蛋白尿的水平呈正相关（r=0．61,P〈0．05）。结论采用苯磺酸氨氯地平联合缬沙坦治疗高血压,效果良好,明显优于单用苯磺酸氨氯地平或缬沙坦。高血压患者的血压变化与蛋白尿水平呈正相关。     

应用动态血压监测评估氨氯地平、培哚普利治疗高血压效果分析

目的观察氨氯地平、培哚普利治疗高血压的效果扣安全性。方法选取42例高血压患者给予氨氟地平、培哚普利联合治疗,通过24h动态血压监测评估治疗4周后患者治疗效果。结果治疗4周后患者收缩压、舒张压均低于治疗前,差异均有统计学意义（P〈0．05）。治疗4周后患者24h、白昼、夜间的收缩压和舒张压均低于治疗前,差异均有统计学意义（P〈0．05）。结论氨氯地平、培哚普利可以有效地降低血压水平,减轻血压负荷。     

Clinical effectiveness of low-dose chlorthalidone (6.25 mg) + atenolol combination in stage I hypertensive patients: a multicenter,randomized, controlled study

ABSTRACT

Objective: To compare the efficacy and safety of low-dose chlorthalidone + atenolol combination with atenolol and atenolol + amlodipine combination in stage I hypertensive patients uncontrolled on active run-in monotherapy.

Methods: Newly diagnosed stage I hypertensive patients were randomized to active run-in monotherapy either with atenolol 25?mg (98/300) or chlorthalidone 6.25?mg (100/300) or amlodipine 2.5?mg (102/300). A total of 282/300 patients (atenolol 92, chlorthalidone 91, amlodipine 99) completed the active run-in phase successfully. Patients uncontrolled on active run-in monotherapy (atenolol 33, chlorthalidone 45, amlodipine 47) received the study treatment, namely atenolol 50?mg alone, chlorthalidone 6.25?mg + atenolol 25?mg and atenolol 25?mg + amlodipine 2.5?mg, respectively. Efficacy of the therapy was evaluated by BP measurement at weeks 12 and 20 post-therapy.

Results: Post-active run-in monotherapies, the study treatment groups showed a significant fall in mean SBP and DBP from baseline (p?<?0.05). The mean fall in SBP and DBP was comparable for study treatments (atenolol 50?mg, atenolol 25?mg + chlorthalidone 6.25?mg and atenolol 25?mg + amlodipine 2.5?mg) (p = 0.337 for SBP and p = 0.054 for DBP) at week 12 and (p = 0.744 for SBP and p = 0.855 for DBP) at week 20; also, the percentage of responders was comparable for the three study treatment groups (p = 0.799) indicating that the low-dose chlorthalidone + atenolol combination is non-inferior to the high-dose atenolol alone and atenolol + amlodipine combination. No serious laboratory/clinical adverse events were reported in this study.

Conclusion: Chlorthalidone 6.25?mg in combination with atenolol 25?mg is effective and safe in stage I (JNC 7) essential hypertensive patients. This low dose of chlorthalidone could reduce dose-related concerns over metabolic adverse effects and may lead to wider usage of this proven antihypertensive agent in combination therapy.     

Long-term tolerability and efficacy of the combination of amlodipine/valsartan in hypertensive patients: a 54-week,open-label extension study*

ABSTRACT

Objective: To evaluate the long-term tolerability and efficacy of the amlodipine/valsartan 5/320?mg once daily (o.d.) combination in hypertensive patients.

Methods: This was a 54-week, multicenter, open-label extension study in patients with mild-to-moderate essential hypertension selected after successfully completing a core study during which they received either placebo, amlodipine, valsartan or combination therapy. Eligible patients (mean sitting diastolic blood pressure [MSDBP] ≤?95?mmHg and mean sitting systolic blood pressure [MSSBP] ≤?150?mmHg; n?=?403) were started with amlodipine/valsartan 2.5/160?mg o.d. Following the initial 2-week treatment period, patients were force titrated to amlodipine/valsartan 5/320?mg o.d. for the remainder of the trial. Only the first 150 patients who successfully completed 28 weeks of the extension study were eligible to continue further treatment for 12 months. Efficacy variables were change from core study baseline in MSDBP and MSSBP at study (extension) endpoint. Safety assessments consisted of monitoring and recording all adverse events and serious adverse events.

Results: Reductions in MSDBP and MSSBP were achieved at each extension visit. At endpoint, the reductions in MSDBP and MSSBP were 17.0 and 24.2?mmHg. Summary statistics by subgroup indicate that the combination of amlodipine/valsartan 5/320?mg was effective regardless of age, gender, or stage of hypertension. Peripheral edema occurred in 1.2% of the patients. No case of edema was classified as serious or severe, and no patient was discontinued due to edema. No deaths or clinically significant laboratory findings were observed during this extension study.

Conclusions: Long-term treatment with the amlodipine/valsartan 5/320?mg combination was well-tolerated. Clinically significant and persistent reductions in blood pressure were achieved. Limitations included an open-label design and inclusion of only those patients at or near goal blood pressure after the preceding core trial.     

Efficacy and safety of a single-pill combination of amlodipine/valsartan in Asian hypertensive patients inadequately controlled with amlodipine monotherapy

Abstract

Objective:

The antihypertensive efficacy of amlodipine/valsartan combination has not been evaluated in Asian patients as previous large-scale studies enrolled very few patients. This multicentre, randomised, double-blind study assessed the efficacy and safety of a single-pill combination of amlodipine/valsartan versus amlodipine in Asian hypertensive patients.     

Efficacy and tolerability of the single-pill combination of aliskiren 300 mg/amlodipine 10 mg in hypertensive patients not controlled by olmesartan 40 mg/amlodipine 10 mg

Abstract

Objective:

We aimed to investigate whether the single pill combination (SPC) of aliskiren 300?mg and amlodipine 10?mg (ALIS 300/AMLO 10) improves blood pressure (BP) reduction in hypertensive patients not adequately controlled by the SPC olmesartan 40?mg and amlodipine 10?mg (OLM 40/AMLO 10).     

左旋氨氯地平联合氯沙坦治疗糖尿病肾病合并高血压

目的探讨左旋氨氯地平、氯沙坦单独治疗和联合治疗对糖尿病肾病合并高血压患者降压效果及对其肾功能的影响。方法60例2型糖尿病肾病合并高血压患者随机分为三组(每组20例),分别给予左旋氨氯地平2.5mg,1次/d;氯沙坦50mg,1次/d;左旋氨氯地平2.5mg及氯沙坦50mg,1次/d;疗程均为12周。治疗后观察降压效果及肾功能变化。结果三组治疗后均能显著降低血压及尿蛋白排泄量(P值均<0.01)。但联合治疗组降低尿蛋白排泄的幅度比单用左旋氨氯地平、氯沙坦组明显高(P值均<0.01),而左旋氨氯地平与氯沙坦组之间则无显著性差异(P<0.05)。结论左旋氨氯地平、氯沙坦长期单独治疗糖尿病肾病合并高血压患者均可明显降低血压,并可减少尿蛋白排出,保护肾功能,但两药联用治疗时保护肾功能疗效更好。     

左旋氨氯地平与厄贝沙坦对高血压病早期肾保护作用的影响

目的评价左旋氨氯地平与厄贝沙坦在高血压病患者早期肾保护作用方面的疗效。方法入选高血压病1级、2级患者71例,随机分为两组:左旋氨氯地平组为35例,口服左旋氨氯地平2.5 mg/d;厄贝沙坦组为36例,口服厄贝沙坦150 mg/d。观察12个月,治疗前、后分别检测肾小球滤过率(GFR)、血、尿β2微球蛋白(β2-MG)及血压。结果①左旋氨氯地平组和厄贝沙坦组在治疗后GFR均升高;厄贝沙坦组的疗效优于左旋氨氯地平组(P<0.01)。②左旋氨氯地平组和厄贝沙坦组在治疗后对血、尿β2-MG的降低差异有统计学意义,厄贝沙坦组的疗效优于左旋氨氯地平组(P<0.05)。③两组在用药后收缩压、舒张压均达到目标值(P<0.01)。两组差异无统计学意义。结论左旋氨氯地平和厄贝沙坦在有效降压的同时,都能不同程度使血、尿β2-MG降低,使GFR升高;厄贝沙坦的作用优于左旋氨氯地平。它们对高血压病早期肾功能有保护作用。     

缬沙坦治疗轻中度高血压疗效和安全性的研究

目的评价缬沙坦治疗轻中度原发性高血压降压疗效和安全性。方法选择轻中度原发性高血压患者132例,采用随机、平行对照的方法,分成缬沙坦组(66例),每日1次80 mg口服;氨氯地平组(66例),每日1次5 mg口服。治疗4周末血压仍>140/90 mm Hg者剂量加倍。在8周观察期内不联用其他降压药。于治疗开始2、4、6、8周末测量诊室坐位谷值血压,同时记录性交次数、自觉症状及不良反应。实验开始前及结束时进行实验室检查。结果两组服药后2、4、6、8周收缩压和舒张压与服药前比较均有明显降低,差异有统计学意义(P<0.01);两组服药后2、4、6、8周血压下降对应组间比较差异无统计学意义(P>0.05);服药8周后,缬沙坦组和氨氯地平组血压达标率分别为89%和88%,组间比较差异无统计学意义。不良反应的发生率分别为缬沙坦组8%,氨氯地平组为6%,组间比较差异无统计学意义。两组试验结束时主要实验室检查指标,除缬沙坦组血钾与试验前比较差异有统计学意义外(P<0.05),其他差异均无统计学意义。缬沙坦组性功能均有不同程度的改善。结论缬沙坦对轻中度高血压患者疗效确切,安全可靠。     

马来酸左旋氨氯地平片治疗轻、中度原发性高血压的疗效和安全性

目的评价马来酸左旋氨氯地平片治疗轻、中度原发性高血压的降压疗效和安全性。方法选择轻、中度原发性高血压患者44例,经过1wk的导入期后,采用阳性药物对照、随机将患者分为试验组22例,口服马来酸左旋氨氯地平2.5~5mg,qd;对照组22例,口服苯磺酸氨氯地平5~10 mg,qd,共治疗8 wk。同时观察2组血压、心率、血尿常规、血糖和肝肾功能。结果试验组和对照组治疗8 wk后,DBP分别从(98.48±5.13)和(99.18±5.23)mm Hg下降至(83.28±5.58)和(83.19±5.79)mm Hg;SBP分别从(156.26±9.81)、(158.23±10.15)mm Hg,下降至(131.50±8.75)、(131.74±7.79)mm Hg,P均<0.01。2组的心率及各项血、尿生化指标治疗前后均无显著差异,不良反应发生率均<5%。结论马来酸左旋氨氯地平片治疗轻、中度原发性高血压患者,在短期内可有效降低DBP与SBP,不良反应发生率低,其疗效及不良反应与苯磺酸氨氯地平基本相同。