两种药物联合治疗老年高血压的临床疗效及安全性

目的：探讨缬沙坦联合氨氯地平或氢氯噻嗪治疗老年高血压的疗效和安全性。方法整群选取2012年11月-2013年11月收治的老年高血压患者75例,随机分为两组,分别给予缬沙坦联合氨氯地平(氨氯地平组,n=36﹚或缬沙坦联合氢氯噻嗪(氢氯噻嗪组,n=31﹚降压治疗,治疗前、后监测两组24 h动态血压,比较两种方案对血压的影响。结果两组治疗12周的24 h平均收缩压(SBP﹚、白昼SBP、夜间SBP、24 h收缩压变异性(SBPV﹚、白昼SBPV均较治疗前降低(P<0.05﹚。治疗12周后氨氯地平组的24 h SBP、白昼SBP和夜间SBP均显著低于氢氯噻嗪组(P<0.05﹚。治疗12周后氨氯地平组的24 h SBPV及白昼SBPV均显著低于氢氯噻嗪组(P<0.01﹚。两组血压达标率和不良反应发生率差异均无统计学意义。结论缬沙坦联合氨氯地平或氢氯噻嗪能有效控制老年人高血压,而缬沙坦联合氨氯地平更适合老年高血压患者。

Clinical Efficacy and Safety of Two Antihypertensive Drugs in Combination in the Treatment of Elderly Patients with Hypertension

Objective To observe the efficacy and safety of valsartan combined with amlodipine or hydrochlorothiazide regi-men in the treatment of elderly hypertensive patients. Methods 75 elderly patients with hypertension admitted from Novem-ber 2012 to November 2013 were randomized into two groups, the amlodipine group (n=36) treated by valsartan and am-lodipine, and the hydrochlorothiazide group (n=31) treated by valsartan and hydrochlorothiazide. 24-hour dynamic blood pressure was monitored at baseline and after the antihypertensive treatment. The effect of treatment on the blood pressure was compared between the two groups. Results The mean 24 h systolic blood pressure (SBP), daytime SBP, nighttime SBP and 24 h systolic blood pressure variability (SBPV), daytime SBPV were lower at 12 weeks of treatment than baseline in both groups (P<0.05). After 12 weeks of treatment, the 24 h SBP, daytime SBP and nighttime SBP were lower in the am-lodipine group than in the hydrochlorothiazide group (P<0.05). After 12 weeks of treatment, the 24 h SBPV and daytime SPBV were lower in the amlodipine group than in the hydrochlorothiazide group (P<0.01). There was no significant differ-ence in the control rate of blood pressure and incidence of side effects between the two groups. Conclusion Both valsartan in combination with amlodipine or hydrochlorothiazide can effectively lower the blood pressure in elderly hypertensive pa-tients, but the former regimen is more suitable for elderly hypertensive patients.