替米沙坦对老年原发性高血压患者降压和改善糖、脂代谢的研究

Investigation of telmisartan decreasing blood pressure and improving glucose,lipid metabolism in elderly patients with hypertension

目的观察替米沙坦对老年高血压患者降压疗效和对糖、脂代谢的影响。方法80例≥60岁的老年高血压患者,停用其他降压药物>2周,口服替米沙坦治疗8周,观察治疗第4周和第8周及治疗前的收缩压(SBP)、舒张压(DBP)、脉压差(PP)、24 h动态血压、餐前血糖(FBS)、餐后2 h血糖(P2hBG)、餐前胰岛素(FINS)、餐后2 h胰岛素(P2hINS)、糖化血红蛋白(HbA1c)及血脂水平。结果与治疗前比较,替米沙坦治疗4周患者SBP、DBP即有明显下降,PP减小(P<0.05)。24 h平均血压、日间平均压和夜间平均压在治疗8周时下降显著(P<0.05)。治疗4周时患者三酰甘油(TG)、P2hBG、FINS、P2hINS、HbA1c明显降低(P<0.05),高密度脂蛋白胆固醇(HDL-C)明显升高(P<0.05)。治疗第8周低密度脂蛋白胆固醇(LDL-C)水平显著下降(P<0.05)。结论替米沙坦除了有较好的降压效果外,还可以改善糖代谢和脂代谢,对于老年高血压病患者尤其是糖、脂代谢紊乱者有较好的疗效。

Objective To investigate the therapeutic effects of telmisartan in decreasing blood pressure and improving glucose, lipid metabolism in elderly patients with hypertension. Methods After two-week withdrawal of anti-hypertensive, 80 elderly patients with hypertension were given telmisartan 80 mg for oral use. The levels of blood pressure ,24 h ambulatory blood pressure and blood glucose and insulin, glycosylated hemoglobin, blood lipids were observed both before and 4, 8 weeks after treatment. Results Telmisartan decreased blood pressure after 4 weeks treatment （ P 〈 0. 05 ）. In comparison with prior treatment, the levels of blood glucose and plasma insulin, glycosylated hemoglobin, the serum triglyceride, LDL-C were decreased significantly, HDL-C was increased significantly（ P 〈 0. 05 ）. Conclusions Telmisartan has good effects in decreasing blood pressure, and it also can improve glucose metabolism,lipid metabolism. It has a better therapeutic effect on elderly patients with hypertension especially the patients with metabolism disturbance.