抗抑郁治疗对老年高血压降压疗效的影响

The effects of antidepressant treatment on efficacy of antihypertensive therapy in elderly hypertension

目的探讨抗抑郁治疗对老年高血压患者降压疗效的影响。方法对138例老年高血压合并抑郁的患者随机分为A、B组,并设103例老年高血压患者对照组,三组均给予氢氯噻嗪12．5mg/d和硝苯地平控释片30 mg/d口服,A组在此基础上加服氟西汀20 mg/d口服,共12周；B组给予阿米三嗪1片和谷维素20 mg,3次/d,共12周。结果A组与治疗前及B组相比,其坐位血压、24 h动态血压监测昼夜收缩压和舒张压均明显下降,差异有显著的统计学意义(P＜0．01)。结论抗抑郁治疗有利于老年高血压合并抑郁患者的血压控制。

Objective To explore the effect of antidepressant treatment on antihyprtensive therapy of senile hypertension. Methods 138 cases of senile hypertension complicating with depression were studied. 103 senile hypertensive patients without depression in the same period served as controls. The patients were randomly divided into 3 groups as A, B and C for study. 12. 5 mg/d hydrochlorothiazide and 30 mg/d release-controlling tablets of nifedipine were orally administrated as basic antihypertnsive medication each group. Besides, 20 mg/d fluoxetine was additionally given to groups A and one tablet of almitrine L/d and 20 mg oryzanol 3/d were given to group B. The treatment lasted 12 weeks. Results In comparison with pre-treatment, the blood pressure at base line in sitting position and the average circadian SBP and DBP monitored with 24-hour ambulatory blood pressure monitoring （ ABPM ） was remarkably decreased in group A with statistical significance （P 〈0. 01 ）. These blood ressure parameters in group B were also decreased as compared ith the pretreatent level brt with less statistical significance （P 〉 0. 05 ）. It was also noted tha with the addition of antidepressant fuoxetine, the manifestations of depression ere alleviated as shown by Hamilton depression （HAMD） scale, untoward reactions such as nausea, perspiration and skin rash were noted in a few patients, but none withdrew from the study. Conclusions Antidepressant and antianxiety treatment is of benefit to the antihyertensive threapy in senile hypertensive patients with complications of depression and / or anxiety neurosis. Based on the results of this study, it is suggested that routine administration of antidepressants and antianxiety drugs should be carried out in senile hypertensive patients complicating with depression or anxiety.