缬沙坦与福辛普利治疗老年高血压病的对照研究

Efficacy of valsartan versus fosinopril in the treatment of aged patients with hypertension

目的:对比缬沙坦和福辛普利对老年轻中度高血压病患者的降压效应、靶器官保护作用和耐受性。方法:开放试验,140例老年轻中度高血压病患者,随机分为缬沙坦组(n=70,口服缬沙坦80～160mg·d^(-1)和福辛普利组(n=70,口服福辛普利10～40mg·d^(-1)),治疗1年。用药前后分别行超声心动图检查和尿白蛋白排泄率测定,用药前和用药2个月后分别行动态血压监测。结果:缬沙坦组和福辛普利组降压治疗的总有效率分别为97.0%和96.9%,差异无统计学意义(P>0.05),两组患者用药1年后,反映左室肥厚程度的超声心动图参数减小,组内比较有统计学意义(P<0.05),两组间比较,差异无统计学意义(P>0.05)。两组患者用药1年后,尿白蛋白排泄率减小,组内比较有统计学意义(P<0.05),两组间比较,差异无统计学意义(P>0.05)。缬沙坦组未见明显的不良反应,福辛普利组出现3例较严重的咳嗽患者。结论:缬沙坦降压作用平稳、均衡,长期用药,对重要靶器官心脏、肾脏有保护作用,耐受性好。

Objective: To compare the efficacy and safety of valsartan versus fosinopril in the treatment of aged patients with mild to moderate hypertension. Methods: An unblended and parallelcontrolled study recruited 140 aged patients with mild to moderate hypertension, who randomly received either oral valsartan 80～160mg daily and oral fosinopril 10～40mg daily for 1 year. Ultrasound cardiography (UCG) and urinary albumin excretion rate (UAER) were measured before and after the 1-year treatment. Ambulatory blood pressure monitoring was performed before and after the 2-month treatment. Results:No significant differences in the overall response rate of valsartan and fosinopril(97. 0% vs. 96. 9 %) were found. After 1-year treatment with valsartan or fosinopril, both indices of left ventricular hypertrophy by UCG and UAER decreased,which showed statistical differences within the group(P<0.05), but no difference between the two groups (P>0. 05), respectively. No significant adverse events were reported in valsartan-treated patients but with 3 cases of severe cough in fosinopriltreated patients. Conclusion: Valsartan therapy can steadily control blood pressure,and show better tolerability in aged patients with mild to moderate hypertension.