缬沙坦治疗老年人单纯收缩期高血压的临床研究

Valsartan in treatment of elderly patients with isolated systolic hypertension

目的研究缬沙坦对老年单纯收缩期高血压患者的降压作用及其对心血管系统的影响。方法49例老年单纯收缩期高血压患者,平均年龄(76.2±6.0)岁。受试对象均给予缬沙坦80～160mg或加用利尿剂氢氯噻嗪12.5mg治疗,疗程为12个月。治疗前后分别作诊室随测血压、24h动态血压监测、心脏超声检查、颈动脉、椎动脉、肾动脉超声和眼动脉超声检查。结果(1)缬沙坦治疗12个月以后,患者诊室随测收缩压显著下降(P<0.05);但24h总体血压、白天及夜间血压均无明显变化;(2)左室短轴缩短率显著升高(P<0.001);(3)颈动脉、椎动脉和肾动脉搏动指数(PI)、阻力指数(RI)显著下降(P<0.05),肾段间动脉及眼动脉PI及RI无明显变化。结论缬沙坦可有效控制老年单纯收缩期高血压患者诊室血压,并改善其左室收缩功能和动脉顺应性。

Objective To investigate the effects of valsartan on the target organ damages in elderly patients with isolated systolic hypertension. Methods Fourth-nine patients were enrolled and were given valsartan 80 160mg/day or valsartan plus hidril 12.5mg/d for twelve months. Detailed examination were performed before and after treatment, including sitting blood pressure, ambulatory blood pressure monitoring （ABPM）, echocardiography, carotid artery ultrasound, vertebral artery ultrasound, renal artery ultrasound and ophthalmic artery ultrasound. Results （1）Blood pressure was effectively controlled after valsartan treatment for 12 months. Sitting systolic blood pressure was significantly decreased（P〈0. 05）. （2） Left ventricular fractional shortening （FS） significantly increased（P〈0. 001） after valsartan treatment. （3） Pulse indexes （PI） and resistant indexes （RI） of carotid arteries, vertebral arteries and renal arteries were significantly decreased（P〈 0. 05）, while no significant change was observed in PI and RI of renal segment arteries and ophthalmic artery. Conclusion Valsartan can effectively control the blood pressure of elderly patients with isolated systolic hypertension. Left ventricular systolic function and the arterial compliance were also improved after treatment.