不同降压方案治疗老年性高血压病低血压发生率研究

Study of the orthostatic hypotension incidence of different schemes for controlling old people hypertension

目的探讨老年高血压患者不同降血压方案体位性低血压的发生及特点。方法选取120例老年高血压病患者,按照随机对照的原则分成4组:A组予氯沙坦钾片每天50 mg口服,如果仍然不能降压达标,视患者情况加量;B组给予苯磺酸氨氯地平片每天5 mg口服,如果仍然不能降压达标,视患者情况加量;C组给予氯沙坦钾片每天50 mg及氢氯噻嗪片12.5 mg口服,如果仍然不能降压达标,视患者情况氯沙坦钾片加量;D组给予苯磺酸氨氯地平片及氢氯噻嗪片12.5 mg口服,如果仍然不能降压达标,视患者情况加氯沙坦钾片50～200 mg口服。所有患者于实验前及实验结束后测量血压,统计低血压发生率并分析。结果虽然卧位、立位血压比较及体位性低血压发生率比较差异无统计学意义(P>0.05),但D组立位0 min及立位2 min血压变化均较小(P<0.05)。结论对于老年性高血压病,选择CCB加小剂量利尿剂联合ARB方案发生体位性低血压的可能性更低,是较好的选择。

Objective To study the orthostatic hypotension incidence of different schemes for controlling old people hyper- tension. Methods One hundred and twenty old patients with hypertension were randomized into group A （30 cases）, group B （30 cases）, group C （30 cases） and group D （30 cases）. The patients in group A took Losartan with the dose of 50 mg qd for 30 days, adding the dose if blood pressure was not controlled; the patients in group B took Amlodipine with the dose of 5mg qd, adding the dose if blood pressure was not controlled; the patients in group C took Losartan with the dose of 50 mg qd and Hydrochlorothiazide with the dose of 12.5mg qd, adding Losartan＇s dose if blood pressure was not controlled; the patients in group D took Amlodipine with the dose of 5mg qd and Hydrochlorothiazide with the dose of 12.5mg qd, adding Losartan with the dose of 50-200mg if blood pressure was not controlled, respectivly. To detect the blood pressures before and after treatment and analyze hypotension incidence of different schemes. Results The patients in group D have a lower blood pressure change in erect position for 0 minute and 2 minutes （P 〈 0.05）. Conclusion The scheme of low dose of CCB, diuretic and ARB may have a lower orthostatic hypotension incidence for old people hypertension.