初始低剂量氨氯地平与替米沙坦或复方阿米洛利联合降压疗效的比较

Comparison of efficacy of low-dose amlodipine plus telmisartan or low-dose amlodipine plus diuretics regimen on blood pressure control in essential hypertension patients

目的：探讨以氨氯地平为基础的联合治疗方案，对原发性高血压患者降压疗效的比较。方法收集51~72岁伴心血管病危险因素的原发性高血压患者55例。采用多中心随机开放对照盲终点评估的临床试验方法将患者随机分为A组（28例）：低剂量氨氯地平（2.5 mg/d）＋复方阿米洛利（半片/d）；B组（27例）：低剂量氨氯地平（2．5 mg/d）＋替米沙坦（40 mg/d），计划治疗随访3年。观察两组原发性高血压患者血压的变化。结果 A、B两组原发性高血压患者的血压达标率分别为 A组85．7%（1年）、89．3%（2年）和96．4%（3年）和B组66.7%（1年）、85．2%（2年）和96.3%（3年），收缩压和舒张压与基线值比较均有显著降低（P＜0．05），但两组间收缩压与舒张压比较差异无统计学意义（ P＞0．05）。结论早期资料分析提示患者多为高危人群，随机分配良好；以氨氯地平为基础的联合治疗均能有效降低血压，仅在第1年氨氯地平联合复方阿米洛利的血压达标率高于氨氯地平联合替米沙坦的血压达标率。

Objective To evaluate efficacy of amlodipine-based antihypertensive combination regimens on blood pressure control in essential hypertension patients. Methods A total of 55 essential hypertensive patients in Guilin were included in this multi-centre randomized, controlled, and blind-endpoint assessment clinical trial. Inclusion criteria were： essential hypertension, 51 ~72 years of age with at least one cardiovascular risk factor and signed consent forms. Patients were randomly assigned to receive either （ group A ） low-dose amlodipine ＋diuretics or （ group B） low-dose amlodipine＋telmisartan. All patients were monitored for the change of their blood pressure o-ver a period of three years. Results Clinical research indicated the blood pressure control rates were： Group A was 85. 7 % （1 year） , 89. 3 % （2 years） and 96. 4 % （3 years） . Group B was 66. 7 % （1 year） , 85. 2 % （2 years） and 96. 3% （3 years） . For all patients from both groups, the systolic and diastolic blood pressure compared＆amp;nbsp;with baseline values were significantly reduced （ P 〈0. 05 ） . However, the systolic and diastolic blood pressure difference between the two groups was not statistically significant （ P 〉0 . 05 ） . Conclusion Early data analysis suggests that most of patients enrolled in this study are from high-risk population, and randomly assigned to two treatment groups. Amlodipine-based antihypertensive combination regimens achieves satisfactory blood pressure control rate. During the first year of treatment, the blood pressure control rate with the double combo of amlodipine and amiloride is much higher than the group with the double combo of amlodipine and aelmisartan.