奥美沙坦与坎地沙坦治疗轻、中度原发性高血压的疗效及安全性比较

目的 评价奥美沙坦24 h降压尤其是降低晨峰血压的效果.方法 120例轻、中度原发性高血压患者随机双盲服用奥美沙坦20 mg或坎地沙坦8 mg,共8周.服药前、服药后8周行动态血压监测(ABPM),比较两组24 h,白昼,下一次给药前4 h、2 h ABPM达标的患者比例.结果 8周后奥美沙坦和坎地沙坦均能有效降低血压,奥美沙坦治疗的24 h血压和白天血压达标率高于坎地沙坦,分别为37%比25%和25%比15%,在动态血压监测的最后2 h、4 h,血压的达标比例奥美沙坦高于坎地沙坦,分别为30%比20%和40%比25%.结论奥美沙坦治疗的高血压患者24 h血压和晨峰血压达标率比例高.奥美沙坦不仅能较好地控制24 h血压,而且能降低与晨峰血压高有关的心血管事件.

The effects of almesartan and candesartan for patients with mild and moderat hypertension

Objective The aim of this study is to assess the 2g-hour antihypertensive efficacy of almesartan, with particular emphasis on blood pressure （BP） control during the early morning period. Methods One hundred twenty patients with mild to moderate hypertension were randomly divided into olmesartan group （n=60, 20 mg/d） or candesartan group （n=60, 8 mg/d） for 8 weeks. 24-hour ABPM recordings were initiated at clinic visits at the beginning of double-blind treatment and 8 weeks after treatment. The proportions of patients who achieved ABPM goal over 24 hours, the daytime and the last 4 and 2 hours of ABPM measurement were compared. Results Both SBP and DBP decreased in two groups after the treatment, and significantly higher proportions of patients treated with olmesartan achieved 24-hour and daytime ABPM goal when compared with candesartan （37% and 25%, 25% and 15%, respectively）. During the last 2 and 4 hours of 24-hour ABPM, the proportion of pa- tiens who achieved BP goal were significantly higher with olmesartan than with candesartan （30% and 20%, 40% and 25%, respectively）. Conclusion The results showed that almesartan-treated patients （20 mg） achieved high- er proportions of ABPM goal over 24 hours and the early morning surge period when compared with candesartan- treated patients （8 mg）. This not only demonstrates that olmesartan （20 mg） provides superior 24-hour BP reduction, but also suggests that olmesartan may provide greater protection against the increased risk of cardiovascular events associated with the early morning BP surge period.