尼群地平、氨酰心安单独与联合抗高血压治疗随机双盲研究

Comparison of Nitrendipine,Atenolol Alone and Combination in Treatment of Hypertension.A Randomized Double blind Study

目的 :比较尼群地平、氨酰心安单用和小剂量联用抗高血压治疗的综合效果。方法 :采用随机双盲并行研究将 5 13例高血压患者 (血压≥ 140 /90 m m Hg)分入三组 :尼群地平组 (尼组 ) 172例 ,平均 2 3m g/d;氨酰心安 (氨组 ) 16 8例 ,平均 42 mg/d,尼加氨组 (尼氨组 ) 173例 ,平均尼 18mg/d+氨 2 6 mg/d。观察 6个月。观察患者血压、心率、体质指数、副作用、生活质量的变化。结果 :用药 1周时各组血压即明显下降 ,二药单用降压效果在第 3月时达高峰 ,联合用药降压在 6月时达最高峰 ,而单用药 6月时收缩压略有回升。达标率联用组最高为 78.8% ,尼组次之。联合用药组撤药率小于二单用组。三组累计副作用相似。联用组能更明显改善患者生活质量的各方面 ,氨组对生活质量也有轻微改善 ,而尼群地平对生活质量的某些方面有轻微负面影响。结论 :小剂量尼群地平与氨酰心安联用较二药单用降压综合效果更好 。

objective:To compare the effects of Nitrendipine,Atenolol Alone and Combination in treatment of hypertension.Methods:In a randomized double blind study,513 patients with blood pressure(BP)≥140/90 mmHg were subdivided into three groups by age(≥60 or <60).There were 172 cases in NG with Nitrendipine 20～30 mg/day,168 cases in AG with Atenolol 25～50 mg/day and 173 cases in NA with Nitrendipine 20 mg/day & Atenolol 25 mg/day.Blood pressure,ECG,CDFI,BMI,adverse effects,quality of life(QOL) were investigated after 6 months treatment.Results:Blood pressure reduced in the first week in all three groups significantly and the greatest reduction occurred in the combination group.The peak of antihypertensive effect of either NG or AG was observed in the third month.But the control rate of combination group (BP<140/90 mmHg) is 78 8% which was higher than 65 2% in NG( P <0 01) and 50 8% in AG ( P <0 01).At the end of the sixth month,the percentages of patients withdrawing from the study in NA,NG and AG were 1 56%,5 6% and 5 6% respectively.Combination therapy has a better QOL and less adverse effect than single therapy.Conclusion:Combination therapy of Nitrendipine and Atenolol was superior to monotherapy of them in antihypertension