伊贝沙坦与苯那普利治疗原发性高血压的疗效比较

Comparison of effects between irbesartan and benazepril monotherapy in essential hypertension

目的 :用 2 4h动态血压监测 (ABPM)的方法 ,比较伊贝沙坦 (Irb)与苯那普利 (Ben)治疗原发性高血压的疗效。方法 :70例 2 4h平均舒张压 (DBP)≥ 85 m m Hg的原发性高血压患者。经 1wk药物洗脱期、2 wk安慰剂期后 ,随机服用 Irb15 0 mg/d,qd或 Ben10 m g/ d,qd。 4wk末坐位 DBP≥ 90 m m Hg者剂量分别加量至 Irb30 0 mg/ d,qd或 Ben2 0 mg/ d,qd,继续服用4wk。分别观察安慰剂期末和 8wk末的 2 4h ABPM值和实验室检查值的变化。结果 :8wk末 Irb组 2 3例中需服 30 0 mg者占 75 % ,Ben组 2 5例中需服 2 0 mg占 85 %。 2组用药后各时点血压均较治疗前降低 ,且可保持血压的昼夜节律。 SBP/ DBP下降值在 2 4h、日间 (6 :0 0～ 2 2 :0 0 )、夜间 (2 2 :0 0～ 6 :0 0 ) Irb组分别为 (16 .2± 11.8) / (10 .0± 7.9)、(18.2± 6 .2 ) / (11.6± 4.5 )、(11.8± 4.0 ) / (7.0± 2 .7) mm Hg;Ben组分别为 (9.9± 10 .4) / (5 .1± 5 .7)、(11.1± 3.4) / (6 .3± 2 .9)、(4 .6± 4.9) / (2 .8±4.1) mm Hg。DBP下降值组间比较 P<0 .0 5 ;SBP下降值组间比较 P>0 .0 5。 2组降压 T/ P均大于 5 0 %。Ben组咳嗽发生率9% ,而 Irb组无。结论 :Irb降压幅度好于 Ben。两药降压的同时均不影响血压昼夜节律 ,降压 T/

AIM: To compare the antihypertensive effects between irbesartan and benazepril by 24 h ambulatory blood pressure monitoring (ABPM). METHODS: Seventy patients with 24 h mean diastolic blood pressure (DBP) ≥85 mmHg (1 mmHg=0 133 kPa) were randomly received either 150 mg irbesartan or benazepril 10 mg once a day for 4 wk, followed by doses doubled for another 4 wk in those patients with Se DBP≥90 mmHg. RESULTS: Blood pressure and heart rate were registered automatically at 20 min interval during day time (from 06:00 to 22:00) and 30 min interval during night time (from 22:00 to 06:00) using Space lab 90217 at baseline and at wk 8. Clinical safety , specific symptoms were examined also at baseline and at wk 2, 4, 6 and 8. 24 h mean SBP/DBP reductions from baseline in 24 h, day time, night time were (16 2±11 8)/(10 0±7 9), (18 2±6 2)/(11 6±4 5), and (11 8±4 0)/(7 0±2 7) mmHg respectively in irbesartan group ( n=23 ) and (9 9±10 4)/(5 1±5 7), (11 1±3 4)/(6 3±2 9), and (4 6±4 9)/(2 8±4 1) mmHg respectively in benazepril group ( n=20 ). There was significant difference in DBP decrease ( P <0 05) between irbesartan group and benazepril group. CONCLUSION: Irbesartan 150 300 mg once daily is more effective than benazepril 10 20 mg once daily in Chinese patients with essential hypertension.