坎地沙坦联合苯磺酸氨氯地平治疗老年高血压的临床观察

Clinical Observation of Candesartan Combined with Amlodipine Besylate in the Treatment of Elderly Hypertension

目的 :观察坎地沙坦联合苯磺酸氨氯地平治疗老年高血压的临床疗效和安全性。方法:156例老年高血压患者随机均分为对照组与观察组。对照组患者给予苯磺酸氨氯地平片5 mg,每日晨起口服,每日1次;观察组患者在对照组治疗的基础上给予坎地沙坦酯片8 mg,口服,每日1次。两组患者疗程均为8周。观察两组患者的临床疗效,治疗前后收缩压(SBP)、舒张压(DBP),空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、微量白蛋白(m Alb)、血肌酐(SCr)及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,HOMA-IR、m Alb、SCr均显著低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者SBP、DBP均低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05);FPG比较差异无统计学意义(P>0.05)。两组患者治疗期间均未见明显不良反应发生。结论:坎地沙坦联合苯磺酸氨氯地平治疗老年高血压疗效优于单用苯磺酸氨氯地平,安全性相当。

OBJECTIVE：To observe the clinical efficacy and safety of candesartan combined with amlodipine besylate in the treatment of elderly hypertension. METHODS：Totally 156 elderly patients with hypertension were randomly divided into control group and observation group. Patients in control group were orally given Amlodipine besylate tablets 5 mg in the morning,once a day. Patients in observation group were orally given Candesartan tablets 8 mg based on the treatment of control group,once a day.The course of both was 8 weeks. The clinical data was observed,including clinical efficacy,systolic blood pressure（SBP）and diastolic blood pressure（DBP）before and after treatment,fasting blood glucose（FPG）,insulin resistance index（HOMA-IR）,24 h urinary albumin total（m Alb）,serum creatinine（SCr）and the incidence of adverse reactions. RESULTS：The total effective rate in observation group was significantly higher than control group;the HOMA-IR,m Alb and SCr in observation group were significantly lower than control group,with significant difference（P〈0.05）. After treatment,the blood pressure in 2 groups was significantly lower than before,and observation group was lower than control group,with significant differences（P〈0.05）;there was no significant difference in the FPG（P〉0.05）. There were no obvious adverse reactions during treatment. CONCLUSIONS：Candesartan combined with amlodipine besylate has better efficacy than only amlodipine besylate in the treatment of elderly hypertension,with similar safety.