缬沙坦与吲达帕胺联合用药对原发性高血压患者动态血压及胰岛素敏感性的影响

目的：探讨缬沙坦与吲达帕胺联合应用对原发性高血压（EH）患者动态血压及胰岛素敏感性的影响。方法：对65例EH患者于治疗前和治疗24周后分别进行动态血压监测（ABPM）和胰岛素敏感性测定。结果：治疗后24h平均pSB、pDB，血压负荷较治疗前均显著降低（P＜0．01）。治疗后血压昼夜节律消失者8例，较治疗前42例显著减少（P＜0．01）。治疗后各时点胰岛素与血糖比值（I／G）均明显下降（P＜0．01），治疗后胰岛素敏感指数（ISD）显著增高（P＜0．01）；治疗后葡萄糖 耐量试验120min和180min两个时点C／I比值比治疗前显著增高（P＜0．01－0．05）。结论：缬沙坦与吲达帕胺联合应用可显著降低EH患者动态血压水平和血压负荷，改善血压昼夜节律，显著改善胰岛素敏感性。

Influence of valsartan combined with indapamide on ambulatory blood pressure and insulin sensitivity in patients with essential hypertension

Aim: To investigate the influence of valsartan in combination with indapamide on ambulatory blood pressure and insulin sensitivity in patients with essential hypertension (EH). Methods: Blood pressure and insulin sensitivity were tested in 65 patients with EH before and 24 weeks after treatment by valsartan and indapamide for 24 weeks. Results: Post-treatment 24 h mean systolic and diastolic blood pressure, and blood pressure load were all significantly lower than those before treatment (P<0.01). The cases of non-dipper circadian variation after treatment decrease (42 to 8, P<0.01). Compared with pretherapy, I/G (insulin/glucose) of OGTT after treatment were significantly lower (P<0.01), and insulin sensitivity index (ISI) was significantly higher (P<0.01). C/I (C-peptide/insulin) was significantly higher at 120 min and 180 min of post-therapy OGTT than those of pretherapy respectively. Conclusion: Valsartan in combination with indapamide could significantly reduce blood pressure, modulate non-dipper circadian variation and improve insulin sensitivity in patients with EH.