不同联合用药方案治疗老年单纯收缩期高血压的对照研究

Contrast study of different medication therapy for senile patients with isolated systolic hypertension

目的比较两种不同抗高血压方案(常规降压药/小剂量常规降压药加硝酸酯类药)治疗老年单纯收缩期高血压(ISH)的降压疗效和安全性。方法176例轻、中度老年ISH患者,随机分为联合组:给予卡托普利(25mg),氢氯噻嗪(12.5mg),单硝酸异山梨酯缓释片(40mg),晨顿服;常规组:给予卡托普利(25mg,2次/d),氢氯噻嗪(25mg,1次/d)。比较两组治疗前后(8w末)的降压疗效及生化指标变化。结果联合组能显著降低收缩压与脉压,降压疗效联合组、常规组分别为93.18%、74.71%,两组比较差异有显著(P<0.05)。两组心率及生化指标与基线值比较差异不显著(P>0.05)。结论联合组小剂量三药联用晨服一次,能有效降低轻中度老年ISH患者的血压,降压效果大于双倍剂量常规二药联用,对代谢无明显不良影响。

Objective To compare the efficacy and safety of two treatments of antihypertension （ general hypotensor and small dose of general hypotensor added with mononitrate） for senile patients with isolated systolic hypertension （ISH）. Methods 176 cases with mild- to-moderate ISH were divided into two groups randomly. All of the patients in the united group were given captopril 25 mg, hydrochlorothiazide 12. 5 mg and isosorbide mononitrate 40 mg per day in the morning. And the patients in the normal group were given captopril 25 mg twice a day and hydroehlorothiazide 25 mg once a day. The course of the treatment was 8 weeks. Blood pressure and biochemical indicator before and after the medicine were measured. Results The effect on systolic pressure and diastolic pressure was obviously in the united group. And the general efficacy of the united group and the normal group were 93.18% and 74. 71% separately, and there was obvious difference between the two groups （P〈0. 05）, There was no obvious difference in heart rate and biochemical indicator between the two groups （P 〉 0. 05 ）. Conclusions The therapy of small dose of captopril, isosorbide mononitrate and hydrochlorothiazide once in the morning can efficiently decrease the blood pressure of senile patients with mild-to-moderate ISH. The therapeutic effect is doubled by double doses of capto- pril and hydrochlorothiazide, which has no bad effect on metabolism.