赖诺普利氢氯噻嗪片治疗老年轻中度原发性高血压效果和安全性的多中心观察

Efficacy and safety of lisinopril hydrochlorothiazide tablets in elderly patients with mild-to-moderate essential hypertension:a multi-center clinical observation

目的探讨赖诺普利氢氯噻嗪片治疗老年轻中度原发性高血压的效果和安全性。方法入选2015年6月至2016年8月就诊于全国16所二级或三级医院心内科门诊的老年1～2级原发性高血压患者,均已服用赖诺普利氢氯噻嗪片≥8周。由经过统一培训的调查医生与患者进行面对面访谈完成调查问卷,并查阅电子和纸质病历收集资料。观察患者治疗前后血压变化,计算血压达标率,观察服药期间不良反应发生情况。结果共入选348例患者,其中男161例(46. 3%),女187例(53. 7%),高血压1级44例(12.6%),高血压2级304例(87.4%)。与基线比较,治疗4周时所有患者诊室收缩压平均降幅达(25±10)mmHg(1 mmHg=0.133 kPa),舒张压平均降幅达(12±6)mmHg;治疗8周时诊室血压进一步下降,收缩压平均降幅达(30±9)mmHg,舒张压平均降幅达(15±6)mmHg,与治疗4周时比较,差异均有统计学意义(均P <0. 001)。治疗4周时,总体血压达标率为70. 1%(244/348);治疗8周时,总体血压达标率达97.1%(338/348),与治疗4周时比较,差异有统计学意义(P <0.001)。患者治疗期间最常见的不良反应为干咳(7.2%,25/348),其他不良反应依次为头晕(0.9%,3/348)和头痛(0.6%,2/348),未报告症状性低血压。结论赖诺普利氢氯噻嗪片治疗老年轻中度原发性高血压疗效确切,且安全性良好。

Objective To explore the efficacy and safety of lisinopril hydrochlorothiazide tablets in the treatment of mild-to-moderate essential hypertension in elderly patients. Methods Between June 2015 and August 2016, elderly outpatients with grade 1 or 2 essential hypertension were enrolled from 16 secondary or tertiary hospitals in China. All subjects had taken lisinopril hydrochlorothiazide tablets for at least 8 weeks. Fluctuations and standard rate of blood pressure and adverse reactions were analyzed via face-to-face questionnaire survey and medical record data review. Results A total of 348 patients were analyzed, including 161 males(46.3%), 187 females (53.7%), 44 patients with grade 1 hypertension(12.6%) and 304 patients with grade 2 hypertension(87.4%). Compared with baselines, the mean systolic blood pressure and diastolic blood pressure decreased by (25±10) and (12±6)mmHg respectively 4 weeks after medication. After 8 weeks of treatment, the mean declines of systolic and diastolic blood pressure were (30±9) and (15±6)mmHg respectively, which were significantly higher than those 4 weeks after treatment. The overall blood pressure compliance rate was 70.1%(244/348) at 4 weeks and 97.1% (338/348) at 8 weeks after treatment(P<0.001). Common adverse reactions were dry cough(25 cases, 7.2%), dizziness(3 cases, 0.9%) and headache(2 cases, 0.6%). Symptomatic hypotension was not reported. Conclusion Lisinopril hydrochlorothiazide tablets show high safety and efficacy in the treatment of mild-to-moderate essential hypertension in the elderly.