氯沙坦、福辛普利及硝苯地平控释剂对原发性高血压患者诊所血压及24小时动态血压作用之比较

目的探讨氯沙坦、福辛普利和硝苯地平控释剂对原发性高血压患者诊所血压及昼夜血压的影响,并进行比较.方法87例轻、中度原发性高血压患者随机分为3组,分别服用氯沙坦50?mg/d(L组,30例)、福辛普利10?mg/d(F组,28例)和硝苯地平控释剂30?mg/d(N组,29例),比较治疗前及治疗4周末对诊所血压(OBP)BFQ、动态血压的影响.结果3组治疗4周末OBP、动态血压均较服药前降低,有显著性差异(WTBXP＜0.05～0.001),3组间无显著性差异;各组均能维持正常的血压昼夜节律,24小时血压谷/峰(T/P)均大于70%;以N组作用显著.各组不良反应发生率分别为F组39.4%、N组43.8%、L组18.2%,N组24小时平均心率较治疗前明显加快(P＜0.05).结论氯沙坦、福辛普利和硝苯地平控释剂均能有效持续降低血压.治疗后硝苯地平控释剂24小时血压谷/峰优于氯沙坦和福辛普利.氯沙坦服药后的耐受性优于福辛普利及硝苯地平控释剂.

Comparison of the Effects of Losartan,Fosinopril and Adala t Gartro-Intestinal Therapeutre System on Office and Ambulatory Blood Pressure in Patients with Essential Hypertension

Objective:This study was aimed at investigation and comparison of effects of losartan,fosinopril and adalat gartro-intestinal therapeutre system (GITS) on office blood pressure (OBP) and ambulatory blood pressure (ABP) in patients with essential hypertension(EH). Methods:Eighty-seven patients with mild to moderate EH were studied.Patients with EH were randomly divided into three groups and were treated with adalat GITS 30*!mg/d (N group,n=29),fosinopril 10*!mg/d(F group,n=28)or losartan 50*!mg/d(L group,n=30)respectively.The Changes of OBP and ABP were compared before and four weeks after treatment. Results:Side effects were 18.2% in L group,39.4% in F group and 43.8% in N group,respectively.OBP and ABP in the three-group patients were all significantly reduced after four-weeks treatment (p<0.05-0.01).The antihypertensive effects among the three different medicines had no statistical differences.Each medicine could keep normal circadian rhythm of blood pressure.The trough to peak ratios were all above 70%.Adalat GITS was superior to the others in T/P ratio,but the average heart rate of 24 hours in N group was more rapidly than before(p<0.05). Conclusion:All the three antihypertensives can significantly and safely decrease blood pressure.Adalat GITS is superior to the others in T/P ratio.Losartan is superior to the others in drug tolerance.