动态血压监测评价苯磺酸氨氯地平和氯沙坦对老年单纯收缩期高血压的降压疗效

Antihypertensive effects of amlodipine besylate and losartan in elderly patients with isolated systolic hypertension evaluated by ambulatory blood pressure monitoring

目的:应用动态血压监测评价苯磺酸氨氯地平和氯沙坦对老年单纯收缩期高血压的降压疗效及谷峰比值(T/P)。方法:60例老年单纯收缩期高血压患者随机分为2组,即氨氯地平组和氯沙坦组,各30例,分别服药治疗8周,于治疗前后测定动态血压、诊室随测血压、心率、生化指标。结果:治疗8周末,2组的诊室随测血压和24h、白昼及夜间平均收缩压、收缩压负荷值均显著降低(P<0.05),而心率则无明显变化。8周末,2组的降压总有效率分别为90%和93%。2组降压幅度比较差异无显著性(P>0.05)。降压T/P比值均大于50%,2组患者出现的不良反应均轻微。结论:氨氯地平与氯沙坦均能平稳、有效、安全地降低老年单纯收缩期高血压,不良反应少,可作为老年单纯收缩期高血压的一线用药。

OBJECTIVE To evaluate the antihypertensive effects and the trough to peak （T/P） ratios of amlodipine besylate and losartan in elderly patients with isolated systolic hypertension by ambulatory blood pressure monitoring. METHODS 60 elderly patients with isolated systolic hypertension were divided into two groups randomly, 30 patients were treated with amlodipine besylate and another 30 patients were treated with losartan for 8 weeks. Ambulatory blood pressure, clinical blood pressure（CBP）, heart rate and biochemical indicators were examined before and after the treatment. RESULTS After 8wk treatment, CBP, mean systolic blood pressure（SBP） of 24 h, daytime and night, load of SBP were significantly reduced（P〈0. 05）, while no significant difference was found in heart rate. The total effective rate of the two groups were 90% and 93% respectively. There was no significant difference in depressurizated amplitude in two groups（P〉0.05）. The T/P ratios were higher than 50% and the adverse effects were mild in two groups. CONCLUSION Both of amlodipine besylate and losartan can reduce the SBP in elderly patients stably, effectively and safely, and has little adverse effects, therefore, they can be first-line antihypertensive agents.