氯沙坦对老年高血压患者血压及尿酸的影响

IMPACT OF LOSARTAN ON BLOOD PRESSURE AND URIC ACID OF SENILE HYPERTENSION

目的探讨氯沙坦对老年高血压患者降压和对尿酸的影响。方法62例老年原发性高血压病患者,按是否合用其他降压药物分成I组(n=32)和II组(n=30),I组为未服用降压药或原服用其他降压药物者经2周清洗期,II组为原单独或联合服用包括氨氯地平、福辛普利、雷米普利和/或氢氯噻嗪,但至少服用氢氯噻嗪12.5mg～25mg,治疗2周血压控制仍不理想者,两组均每日晨间口服氯沙坦50mg,观察治疗前和治疗后第3天、2、4、6、8周血压、血尿酸和24小时尿尿酸变化。结果1.I组和II组在2周内的降压有效率分别达71.9%和76.7%。2.单独或联合氯沙坦治疗后3天血尿酸显著降低(P<0.01),24小时尿尿酸明显增加(P<0.01),治疗后2、4、8周血尿酸仍低于治疗前,24小时尿尿酸高于治疗前(P<0.01,P<0.05)。3.治疗前后血尿酸和24小时尿尿酸改变幅度与收缩压和舒张压下降幅度均不相关。结论氯沙坦对老年高血压在有效降压的同时能促进尿尿酸排泄,降低血尿酸,对尿酸的影响不依赖于血压的降低。

Objective To study the impact of losartan on blo od pressure and uric acid in senile hypertensive patients.Methods 62cases of primary senile hypertensive patients were divided into group I(n =32)and Group II(n =30)according to the usage of other antihypertensive s.Group I included patients never ta king any antihypertensive drugs or a fter 2weeks of wash -out period with original antihypertensive drugs.Group II included patient s taking mono or combined therapy lik e amlodipine,fosinopril,ramipril and /or hydrochlorothiazide,but at least taking 12.5mg to 25mg hydrochlorothiazide.The blood pre ssure was not well controlled after two weeks therapy with all these drugs in group II.Losartan 50mg were taken daily in the morni ng by all patients in group I and II for 8weeks.Blood pressures were monitored before and after3days ,2,4,6and 8weeks of therapy .Blood and 24hours urinary uric acid were detecte d before and after 3days ,2,4and 8wee ks of therapy.Results1.The effects of antihy-pertension of losartan were 71.9%an d 76.7%after two weeks therapy in gro up I and II.2.Mono or combined therap y with losartan reduced blood uric acid and increased 24hours urinary uric acid prominently(P<0.01)after 3days ,and maintained the low level of blood uric acid and high l evel of urinary uric acid after 2,4an d 6weeks(P<0.01,P<0.05).3.The changing of blood and 24hours urinary uric acid were irrelevant to the decreasing o f systolic and diastolic pressure.Conclusions Losartan can decrease blood pressure effectively in senile hypertension and can i ncrease the excretion of urinary uric acid and hence decrease blood uric acid.The impact on uric acid doesn' t rely on the decrease of blood pressu re.[