奥美沙坦治疗老年轻中度原发性高血压患者的效果及安全性研 究简

目的 通过与氯沙坦钾比较评价奥美沙坦治疗老年人轻、中度原发性高血压患者的效果和安全性.方法 将106例研究对象随机分为研究组与对照组,分别接受口服奥美沙坦酯20 mg或氯沙坦钾50 mg治疗,qd.用药4周后对患者进行血压评价,如果患者平均舒张压（SeDBP）仍≥90 mm Hg（1 mm Hg=0.133 kPa）,则药物剂量加倍,直至8周试验结束;否则维持原剂量继续治疗至第8周.结果 治疗8周后研究组和对照组患者收缩压（SBP）分别为（133.29±14.05）mm Hg和（138.96±14.17）mm Hg,舒张压（DBP）分别为（84.59±7.64）mm Hg和（88.01±7.83）mm Hg,差异均有统计学意义（t=2.069,P=0.041;t=2.276,P=0.025）.研究组降压的总有效率为83.02％,优于对照组的77.36％,差异无统计学意义（x2=0.726,P=0.696）.24h动态血压监测显示,治疗8周后研究组患者DBP和SBP的谷/峰比值均高于对照组.研究组和对照组药物有关的不良事件的发生率分别为3.77％和7.55％,差异无统计学意义（x2=0.177,P=0.674）.不良反应症状均轻微,不需停药接受特殊治疗.结论 奥美沙坦酯每日口服20～40 mg能够有效、安全地治疗高血压.与氯沙坦钾50～100 mg降压作用相比,奥美沙坦24 h内持续降压时间更长,降压效果更好.

Study on clinical efficacy and safety of Olmesartan in elderly patients with mild to moderate primary hypertension

Objective To evaluate the efficacy and safety of Olmesartan compared with Losartan in elderly patients with mild to moderate primary hypertension.Methods A total of 106 subjects were randomly divided into the study group and the control group,which were treated with Olmesartan Medoxomil 20 mg or Losartan Potassium 50 mg,once daily for 8 weeks.The blood pressure was assessed after 4 weeks treatment.If the subject＇s seating diastolic blood pressure （SeDBP） was still≥ 90 mm Hg （1 mm Hg=0.133 kPa）,the dosage was doubled for another 4 weeks：for the other patients,the initial dosage remained unchanged.Results The mean SBP and DBP of the study group and the control group were reduced to （133.29±14.05） mm Hg vs （138.96±14.17） mm Hg and （84.59±7.64） mm Hg vs （88.01±7.83） mm Hg respectively after 8 weeks treatment,the differences were statistically significant （t =2.069,P =0.041; t =2.276,P =0.025）.The effective rates were 83.02% and 77.36% respectively,no statistically significant was found （x2=0.726,P =0.696）.The through/peak ratios of DBP and SBP in 24-hour ambulatory blood pressure monitoring were higher in the study group than the control group.The incidence of drug-related adverse events （AEs） in the study group （3.77%） was similar than that in the control group （7.55%）,but was not statistically significant （x2--0.177,P =0.674）.All of these AEs were mild and transient.Conclusion Olmesartan,at dose of 20-40 mg once daily,is effective and safe for hypertension testament.Compared with Losartan （50-100 mg once daily）,Olmesartan has longer duration of efficacy within 24 h and antihypertensive effect is better.