硝酸酯类药物对老年单纯收缩期高血压的有益作用

目的　观察硝酸酯类药物对老年单纯收缩期高血压 (ISH)患者降压治疗的有益作用。方法　 87例ISH患者随机分为对照组 4 6例和治疗组 4 1例 ,对照组给予非洛地平缓释片 5mg ,每日一次口服 ,治疗组在上述治疗的基础上给予加用单硝酸异山梨酯 (ISMN) 2 0mg ,每日二次口服 ,疗程8周。结果　 (1)治疗组从第 2周开始收缩压 (SBP)下降幅度即大于对照组 ,且先于对照组于第 4周降至正常 ,差别有显著性 (P <0 0 5 ) ;(2 )从第 2周开始治疗组舒张压 (DBP)下降幅度即小于对照组(P <0 0 5 ) ,第 6周开始差距进一步加大 ,差别有显著性 (P <0 0 1) ,整个观察期内治疗组DBP下降幅度始终小于对照组 ,且从第 4周开始处于相对稳定状态 ;(3)第 2周开始治疗组PP下降幅度即大于对照组 (P <0 0 5 ) ,第 4周开始差距进一步加大 ,差别有显著性 (P <0 0 1)。结论　硝酸酯类药物能降低ISH患者的SBP ,而对DBP影响不大 ,使PP减小 ,对ISH患者降压治疗的有益。

Beneficial Effect of Nitrates on Isolated Systolic Hypertension in the Elderly

Objective To investigate the beneficial effect of nitrates on isolated systolic hypertension(ISH) in elderly. Methods Eighty-seven patients we re randomized to receive felodipine (5 mg/d) or felodipine combined with isorbide mononitrate (ISMN 20 mg/d) for 8 weeks. Dynamic changes in SBP, DBP were determined. Results (1)From the 2 nd week of treatment, the magnitude of reduction in SBP was greater in combination group than that by felodipine alone, which was persisted until the end of the study. However, the magnitude of reduction in DBP was less than that by felodipine alone. The greater reduction of SBP and less reduction in DBP resulted in significant decreases in pulse pressure in combination group(-26 mmHg) in relative to alone group(-7 mmHg)(P<0.01). Conclusion Nitrates decreased SBP in ISH and had less effect on DBP, leading to decreased in PP which was speculated beneficial to elderly.