不同联合降压方案对高血压患者血压和脉搏波传导速度的影响

目的探讨不同药物的联合降压治疗方案对高血压患者血压和脉搏波传导速度(PWV)的影响。方法选择2008年1～9月在北京医院心内科门诊就诊的高血压患者66例,其中男性36例,女性30例,年龄50～75岁,平均(60.7±7.5)岁。将研究对象随机分为两组:一组患者采用氨氯地平+复方阿米洛利(A组)治疗,另一组患者采用氨氯地平+替米沙坦(B组)治疗。观察不同的联合降压方案对血压、心率、肱踝动脉PWV(baPWV)、血脂、血糖、肌酐和尿酸的影响。结果两种治疗方案均有良好的降压作用,A组平均收缩压和舒张压由(154.4±12.7)mm Hg和(89.1±7.4)mm Hg分别降至(127.7±11.2)mm Hg和(74.8±8.8)mm Hg(均为P<0.01);B组平均收缩压和舒张压由(155.0±12.9)mm Hg和(90.9±10.1)mm Hg分别降至(128.6±9.9)mm Hg和(77.7±9.0)mm Hg(均为P<0.01)。治疗前和治疗后及两组之间比较,治疗方案对baPWV、心率、血脂、血糖和肌酐无明显影响。B组治疗后尿酸水平由治疗前的(335.8±58.5)μmol/L上升到(361.4±51.3)μmol/L(P=0.017)。结论两种联合治疗方案均有良好的降压作用,对baPWV均无显著影响。

Effects of different antihypertensive combinations on blood pressure and pulse wave velocity in hypertensive patients

Objective To study the effects of different antihypertensive combinations on blood pressure and pulse wave velocity(PWV) in hypertensive patients. Methods Sixty-six hypertensive patients,including 36 males and 30 females,aged from 50 to 75(mean age 60.7±7.5 yr),who admitted to Cardiology Department of Beijing Hospital from January 2008 to September 2008,were enrolled in this study.All the patients were randomly divided into 2 groups,treated with amlodipine-compound amiloride(Group A) or amlodipine-telmisartan(Group B) respectively.Blood pressure,heat rate,brachial ankle pulse wave velocity(baPWV),blood lipid,blood sugar,serum creatinine and uric acid level were measured and compared between the 2 groups. Results Blood pressure in both groups was decreased significantly.The systolic and diastolic blood pressures decreased from(154.4±12.7)/(89.1±7.4) mm Hg to(127.7±11.2)/(74.8±8.8) mm Hg in group A(P<0.01) and from(155.0±12.9)/(90.9±10.1) mm Hg to(128.6±9.9)/(77.7±9.0) mm Hg in group B(P<0.01).Both combinations had no influence on brachial ankle pulse wave velocity(baPWV),heat rate,blood lipid,blood sugar or serum creatinine.But in group B,serum uric acid level was increased significantly from(335.8±58.5) μmol/L to(361.4±51.3)μmol/L(P=0.017). Conclusions Both antihypertensive combinations have good blood pressure lowering effect with no impact on baPWV.