硝酸酯类联合降压降脂治疗对老年单纯收缩期高血压的影响

目的观察硝酸酯类和他汀类药物对老年单纯收缩期高血压（ISH）伴高脂血症患者血压、血脂及大动脉结构的影响.方法 96例老年ISH伴高脂血症患者随机分为单硝酸酯三联组（A组）：给予单硝酸异山梨酯、辛伐他汀和非诺地平治疗;辛伐他汀二联组（B组）：给予辛伐他汀和非诺地平治疗;对照组（C组）：单用非诺地平治疗,疗程均为12周.于试验期间观察血压、血脂及大动脉结构等变化.结果 A组的降压疗效明显优于B组、C组（ P＜0.01）,A组与B组的降脂效果及颈动脉内膜厚度的变化均优于C组（ P＜0.05）.结论硝酸酯类药物能降低老年ISH患者的收缩压,使脉压减小,而对舒张压影响不大;他汀类药物可干预、延迟大动脉内膜中层增厚进程,两药合用,有益于控制老年ISH.

Effect of the nitrates combined therapy of decreasing blood pressure and lowering lipid on isolated systolic hypertension in elderly

ObjectiveTo observe the effect of nitrates and statins on blood pressure,serum lipid and artery structure of elderly patients with isolated systolic hypertension(ISH) and hyperlipidemia.Methods96 elderly patients with ISH and hyperlipidemia were randomly divided into the isosorbide mononitrate triple therapy group(group A),simvastatinelderly two drugs combination group(group B) and control group(group C) with 32 cases in each group.The group A was given isosorbide mononitrate,simvastatinelderly and felodipine.The group B was given simvastatinelderly and felodipine.The group C was given felodipine alone.The whole course lasted 12 weeks and the blood pressure,serum lipid and the change of artery structure were observed.ResultsThe effect of group A was significantly better than groups B and C(P<0.01). The effect of lowering serum lipid and change of artery intima-media thickness(IMT) in groups A and B were better than that in group C(P<0.05).ConclusionNitrates can decrease systolic blood pressure and pulse pressure,but has less effect on diastolic blood pressure.Statins can decrease IMT of the common arteries.The combination of nitrates and statins is speculated beneficial to elderly with ISH.