单硝酸异山梨酯合用不同降压药对社区老年高血压患者血压的影响

目的：探讨单硝酸异山梨酯缓释片与各种降压药联合应用的降压效果，并观察其不良反应。方法：选取2013年10月至2015年6月门诊收治的高血压患者112例，分为血管紧张素转换酶抑制剂组（ACEI组）36例，血管紧张素Ⅱ受体拮抗剂组（ARB组）39例，钙通道阻滞剂组（CCB组）37例。三组患者在服用原药基础上，均加用单硝酸异山梨酯缓释片40 mg/d，随访2个月，观察血压变化以及不良反应的发生情况。结果：2个月后，三组患者血压均有下降，并以ACEI组的降低幅度最为明显，与其他两组相比差异有统计学意义（P＜0.01）。三组共有7例发生头痛等不良反应，其中4例因不良反应退出研究。结论：单硝酸异山梨酯缓释片具有协同降低血压作用，不良反应较少，与ACEI合用，降压作用更为明显。

Effect of isosorbide mononitrate combined with different kinds of antihypertensive drugs on the blood pressure of the elderly hypertensive patients in the community

Objective:To study the antihypertensive effect of isosorbide mononitrate sustained release tablet combined with different kinds of antihypertensive drugs and observe their adverse reactions.Methods: From Oct 2013 to June 2015, 112 cases of hypertension in the outpatient department were selected and divided into an angiotensin converting enzyme inhibitor group with 36 cases(ACEI group), and an angiotensin II receptor blockade group with 39 cases(ARB group) and calcium channel blockers with 37 cases(CCB group). On the basic antihypertensive treatment, all patients were added with isosorbide mononitrate sustained release tablet 40mg/day. After following-up for 2 months, the blood pressure changes and adverse reactions were observed.Results:After 2 months, the blood pressure of the patients in three groups decreased obviously(P<0.05), and the decrease of blood pressure in ACEI group was more obvious and compared with the other two groups, the difference had the statistical signiifcance(P<0.05). A total of 7 patients had a headache and other adverse reactions in the three groups, of whom 4 cases withdrew from the study due to adverse reactions.Conclusion: Isosorbide mononitrate sustained release tablet has a synergistic effect on reducing blood pressure, the adverse reaction is less and combined with ACEI, antihypertensive effect is more obvious.