坎地沙坦与培哚普利治疗老年高血压病的疗效观察

目的：探讨坎地沙坦联合苯磺酸氨氯地平治疗老年高血压病的疗效、安全性及对代谢指标的影响。方法：老年高血压病患者单独服用苯磺酸氨氯地平片5mg/d,2周后血压未降至150/90mmHg以下者70例,随机分为两组,坎地沙坦联合组36例,每日晨加服坎地沙坦8mg;培哚普利联合组34例,每日晨加服培哚普利4mg,两组疗程均为8周,观察联合用药前后动态血压变化,血尿酸及胱抑素-C变化。结果：第8周末,两组血压水平均较分组前降低（P〈0.001）,坎地沙坦联合组收缩压及舒张压下降幅度大于培哚普利联合组（P〈0.05）,两组脉压缩小程度间差异无统计学意义（P〉0.05）。两组血尿酸及胱抑素-C水平均较观察前降低（P〈0.001）,坎地沙坦联合组血尿酸及胱抑素-C下降幅度均大于培哚普利联合组。结论：坎地沙坦联合苯磺酸氨氯地平能有效降低老年高血压病患者的血压水平,缩小脉压,降低血尿酸及胱抑素-C水平。

Effects of Candesartan compared with Perindopril in elderly hypertensive patients

Objective：To evaluate the safety and efficacy of Candesartan plus Amlodipine Besylate in elderly patients with hypertension.Methods：The elderly patients with hypertension took Amlodipine Besylate 5 mg daily alone.After two weeks＇ treatment,70 cases with blood pressure over 150/90 mm Hg were randomly divided into two groups,36 cases of Candesartan group treated with Candesartan 8 mg daily;34 cases of Perindopril group treated with Perindopril 4 mg daily,they were treated for 8 weeks,the ambulatory blood pressure,blood uric acid and cystatin-C of two groups were compared.Results：After 8 weeks＇ treatment,the blood pressure of two groups reduced,the differences were statistically significant（P0.001）,the decrease range of SBP and DBP in the Candesartan group were more than those of the Perindopril group（P 0.05）,the PP was also reduced in the two groups,but there was no significant difference（P0.05）.In the two groups,the blood uric acid and cystatin-C were lower than those before treatment（P0.001）,the decrease range of blood uric acid and cystatin-C in the Candesartan group were more than those of the Perindopril group.Conclusion：Candesartan combined Amlodipine Besylate can effectively reduce blood pressure and pulse pressure in elderly hypertensive patients,and can effectively reduce the lever uric acid and cystatin-C.