氯沙坦、培哚普利及联用吲哒帕胺治疗老年1、2级原发性高血压的疗效比较

目的 :评价氯沙坦、培哚普利及联用吲哒帕胺治疗老年 1、2级原发性高血压的临床疗效和安全性。方法 :77例老年 1、2级原发性高血压患者随机分为两组 :氯沙坦组 (n=3 8)用氯沙坦 5 0 mg/d;培哚普利组 (n=3 9)用培哚普利4mg/d,4周后未达目标血压 (<18.7/12 k Pa)者加用吲哒帕胺 2 .5 mg/d。结果 :经 8周治疗 ,两组药物均有显著的降压作用 (P<0 .0 1) ,氯沙坦组达标率 86.8% ,培哚普利组达标率 87.1% (P<0 .0 5 )。氯沙坦组和培哚普利组分别有 17例和 16例加用吲哒帕胺 (P>0 .0 5 )。两组不良反应发生率无显著性差别。结论 :氯沙坦和培哚普利治疗老年 1、2级高血压安全有效 ,与吲哒帕胺联用 ,能有效治疗氯沙坦或培哚普利单药治疗无效者

Comparison of losartan and perindopril and each of them in combination with indapamide in the treatment of older patients with grades 1 and 2 hypertension

Objective:To compare the efficacy and safety of losartan and perindopril and each of them in combination with indapamide in the treatment of older patients with grades 1 and 2 hypertension.Methods:77 older patients with grades 1 and 2 hypertension entered an eight-week randomized study with either 50mg losartan (n=38) or 4mg perindopril (n=39) once daily.The addition of indapamide 2.5mg once daily to each group was required if blood pressure was more than 18.7/12 kPa at the end of four weeks′ monotherapy.Results:At the end of eight weeks′ therapy,blood pressure was significantly lowered in both groups ( P <0.01).There was no significant difference in respondence rates between losartan-treated group (86.8%)and perindopril-treated group(87.1%).17 of the 38 persons in losartan-treated group required the addition of indapamide compared with 16 of the 39 persons in perindopril-treated group( P >0.05).There was no significant difference in the incidence of adverse reactions in both groups.Conclusion:Both losartan and perindopril are effective and safe in the treatment of older patients with grades 1 and 2 hypertension.In combination with indapamide,they were effective in the subgroup of older patients that blood pressure could not be effectively controlled by monotherapy.