氨氯地平对稳定型心绞痛患者发生心血管意外的影响

目的:探讨苯磺酸左旋氨氯地平能否降低心绞痛患者发生心血管意外的风险。方法:对1 287例稳定型心绞痛患者,在用药2周后检测血压变化,比较长效氨氯地平和安慰剂的药效差异,并分析血压变化对药物和继发心血管病结果关系的影响。结果:服用氨氯地平后能明显减少心绞痛患者发生心血管意外的危险性,用药2周后收缩压的变化与心血意外事件的发生密切相关,但冠状动脉介入治疗和心脏搭桥手术与血压变化没有关系。对2周后收缩压变化进行校正后发现使用氨氯地平能使患者发生中风的风险从27%(P=0.03)降到20%(P=0.12),发生心力衰竭的风险从31%(P=0.03)降到21%(P=0.12),行冠状动脉介入治疗的比例降低26%(P=0.003),行冠状动脉搭桥手术的比例降低22%(P=0.01)。结论:氨氯地平能有效降低稳定型心绞痛患者心血管意外的风险,临床上为减少心绞痛患者发生心血管意外,要尽早应用药物降低血压。

Effects of amlodipine on cardiovascular accidents in patients with stable angina pectoris

OBJECTIVE To study whether cardiovascular accidents can be decreased by amlodipine in patients with stable angina pectoris.METHODS A total of 1 287 patients with stabile angina pectoris were enrolled in this study. Blood pressures were determined 2 weeks after drug administration. Difference of efficacy was observed between long-term administration of amlodipine and placebo. Effects of blood pressure changes were analyzed on correlation between amlodipine and secondary cardiovascular diseases.RESULTS Amlodipine significantly reduced risk of cardiovascular accidents in patients with stable angina pectoris. After drug administration for 2 weeks, cardiovascular accidents were strongly related to SBP decrease, but cardiac artery bypass operation was not. Amlodipine reduced risk of stroke from 27% (P=0.03) to 20% (P=0.12), heart failure from 31% (P=0.03) to 21% (P=0.12), reduced cardiac intervention by 26% (P=0.003) and cardiac bypass operation by 22% (P=0.01).CONCLUSION Amlodipine can effectively reduce risk of cardiovascular accidents in patients with stable angina pectoris. Relevant drugs should be early administered to lower blood pressure and reduce occurrence of cardiovascular accidents in patients with stable angina pectoris.