用动态血压监测的方法评价氯沙坦治疗原发性高血压的疗效

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

目的：应用２４ｈ动态血压监测（ＡＢＰＭ）的方法评价氯沙坦治疗原发性高血压的降压疗效、谷／峰比值及药物不良反应。方法：采用开放的方法，５５例原发性高血压患者经１周药物洗脱期，２周安慰剂期后，服用氯沙坦５０ｍｇ，每日一次。 ４周末坐位舒张压≥９０ ｍｍＨｇ者，加量至氯沙坦 １００ｍｇ，每日一次继续服用４周。于安慰剂期末及治疗８周末各行ＡＢＰＭ和实验室检查一次。结果：ＡＢＰＭ结果显示８周末较安慰剂期末于２４ｈ、日间（６：００－２２：００）、夜间（２２：００－６：００）的收缩压／舒张压分别下降（１１．０±９．５／６．８．８±５．８）、（１１．５±１０．８／７．０±６．２）、（１０．２±９．５／６．６±７．０）ｍｍＨｇ。降压Ｔ／Ｐ值ＳＢＰ为７４．５％， ＤＢＰ为７５．５％。有头晕２例，无咳嗽等药物不良反应。结论：氯沙坦５０－１００ｍｇ，每日一次可以维持２４ｈ降压疗效，耐受性好。

OBJECTIVE: To assess 24h ambulatory blood pressure lowerings and tolerability after & weeks of therapy with losartan 50-100mg once daily. METHOD: After 1-week wash-out and 2-weeks placebo run-in, patients with seated diastolic blood pressure (SeDBP) 95-115mmHg and ambulatory diastolic blood pressure ≥ 85 mmHg were investigated by openlabel method with losartan 50mg treatment for 4 weeks, followed by dose titration to 100mg once-daily for another 4 weeks in those patients with SeDBP≥90mmHg. Ambulatory blood pressure monitoring (ABPM) was performed over 24-hour period after placebo run-in and at the end of & weeks. RESULTS:Mean reductions from baseline in 24h, day -time (6:00-22:00), night-time (22:00-6:00) were (11.0 ?9.5/6.8 ?5.8),(11.5 ?10.8/7.0 ?6.2),(10.2 ?9.5/6.6 ? 7.0) mmHg. Trough: peak ratios were 75.5% for DBP and 74.5% for SBP. The frequency of adverse events was very low, and no cough happened. CONCLUSION: losartan 50- 100mg given once daily appears to be a well-tolerated, safe,and effective antihypertensive treatment.