用24小时动态血压监测评价伊贝沙坝(irbesartan)治疗轻、中度原发性高血压的疗效

24-Hour Blood Pressure Control by Once-daily Administration of Irbesartan Assessed by Ambulatory Blood Pressure

目的：应用诊室血压（ＣＢＰ）和动态血压监测（ＡＢＰＭ）的方法评价伊贝沙坦（ＩＲＢ）治疗轻中度原发性高血压的降压疗效、谷／峰比率及药物不良反应。方法：采用开放的方法，２３例研究对象经１周药物洗脱期，２周安慰剂期后，服用伊贝沙坦每日一次１５０ｍｇ， ４周末ＳｅＤＢＰ≥ ９０ ｍｍＨｇ者加量至ＩＲＢ每日一次３００ｍｇ，继续服用４周。于安慰剂期末及伊贝沙坦治疗４，８周末测ＣＢＰ、心率并记录体征；于安慰剂期末及治疗８周末各行ＡＢＰＭ和实验室检查一次。ＣＢＰ结果显示８周末总有效率７８％。４，８周末ＳｅＳＢＰ／ＳｅＤＢＰ分别下降（１５．４±１１．５／１０．９±８． ３）和（２２． ３±１０．４／１４．９±１０．４） ｍｍＨｇ。ＡＢＰＭ结果显示 ８周末２４ｈ、日间、夜间血压分别下降（１６．８±６．４／１０．６±４．５）、（１８．１±６．１／１１．８±４．３）、（１０．１±４２．４／７．５±２．６）ｍｍＨｇ。降压Ｔ／Ｐ大于５０％。无咳嗽等药物不良反应。结论：本研究结果表明，伊贝沙坦每日一次１５０～３００ｍｇ为疗效确切、耐受性好的降压药物。

OBJECTIVE: To assess 24h ambulatory blood pressure and office blood pressure lowerings and tolerability after & weeks of therapy with irbesartan (IRB) 150-300mg once a day. METHOD: After 1-week wash-out and 2 -week placebo run-in, 23 patients with seated diastolic blood pressure(SeDBP) 95-115 mmHg and ambulatory diastolic blood pressure(ADBP) ≥ 85 mmHg were investigated by open-label method with irbesartan 150mg treatment for 4 weeks, followed by dose titration to 300mg once-daily for another 4 weeks in those patients with SeDBP ≥ 90 mmHg. Clinical blood pressure(CBP) and heart rate(HR) and sideeffects were assessed during placebo period and at the end of weeks 2,4,6,8. Both ambulatory blood pressure monitoring(ABPM) and laboratory test were performed over 24-hour period after placebo run-in and at the end of weeks 8. RESULTS: The favorable responder rate(nomalised or ≥ 10mmHg of trough SeDBP reduction) of IRB 150-300mg once-daily was 78%. Mean changes (n=23) in trough SeSBP/ SeDBP were -15.4/-10.9, -22.31-14.gmmHg at weeks 4, 8. Reductions SBP/ DBP from baseline in 24h,day-time(4:00-22: 00),night-time(22:00-4: 00) were -16.8/-10.6, -18. 1/-11 .8, -10. 1/-7.5 mmHg. Trough: peak ratio were more than 50% for ADBP and ASBP. The frequency of adverse events were very low, and no cough happened. CONCLUSION: IRB 150-300mg given once daily appears to be a well-tolerated, safe and effective anhhypertensive treatment.