厄贝沙坦单用及合用治疗轻、中度原发性高血压60例

Antihypertensive effects of irbesartan single and combined treatments on 60 patients with mild to moderate essential hypertension

目的 :比较国产厄贝沙坦单用以及与非洛地平或雷米普利合用对轻、中度原发性高血压的降压疗效。方法 :6 0例轻、中度高血压病人 ,经 2wk安慰剂导入期后 ,单服厄贝沙坦 15 0mg ,qd。 4wk后随机分 2组 ,分别联合服用非洛地平 5mg ,qd ,或雷米普利 5mg ,qd ,均为 4wk。治疗前及治疗后 4wk和 8wk行 2 4h动态血压监测 ,并测治疗前后坐位血压。结果 :厄贝沙坦单用 4wk后 ,坐位血压和2 4h动态血压均下降 (P <0 .0 5或P <0 .0 1) ,收缩压和舒张压的谷峰比值为 0 .82和 0 .86。厄贝沙坦与非洛地平或雷米普利合用 4wk后 ,坐位血压总有效率从 4 0 %增加为 89%和 70 % ;动态血压显示联合用药降压作用较明显。结论 :厄贝沙坦单用有长效的降压作用 。

AIM: To study antihypertensive effects of irbesartan used alone and combined with felidipine or remipril on patients with essential hypertension. METHODS: Following 2 wk placebo lead-in period, 60 patients received irbesartan 150 mg, po,qd for 4 wk, then, followed by combination with felodipine 5 mg, po, qd (n=27) or remipril 5 mg, po, qd (n=33) for another 4 wk. Blood pressure changes were derived from clinic measurements (at 0, 2, 4, 6 and 8 wk of treatment ) and 24-hour BP ambulatory monitoring (at 0, 4 and 8 wk ). RESULTS: After 4 wk of irbesartan monotherapy, seated systolic and diastolic blood pressure were decreased significantly(P<0.01) and the total response rates of seated BP were 40 %; 24-hours ambulatory blood pressure were lowered (P<0.05) and trough/peak ratio for SBP and DBP were 0.82 and 0.86, respectively. After 4 wk of combined treatments, the total responder rates of seated BP were 89 % for felodipine group and 70 % for remipril group, and the antihypertensive effect of the former was better than that of the latter by 24-hours BP ambulatory monitoring. CONCLUSION: The irbesartan single provided the patients with clinically significant sustained BP reductions over a full 24 hours, and the combination therapies showed an additive antihypertensive effect.