不同单片复方制剂降压治疗对高血压心脏病预后研究

Research on the Implication of Different Single Pill Combination Antihypertensive Therapies for the Prognosis of Hypertensive Heart Disease

目的探讨应用不同新型单片复方制剂降压治疗对高血压心脏病预后研究。方法随机抽取161例高血压心脏病性心衰患者,分别采用缬沙坦/氨氯平地片80mg/5mg(1次/d)与缬沙坦/氢氯噻嗪片80mg/12.5mg(1次/d)治疗,对比分析两组患者治疗2年后的血压达标率、不良反应发生率、一级疗效终点发生率(心衰,急性冠脉征、卒中)。结果两组患者血压达标率、不良反应发生率比较差异无统计学意义(P>0.05),一级疗效终点主要心血管事件发生率比较差异有统计学意义(P<0.05),其中缬沙坦/氢氯噻嗪片组心衰事件发生率低于缬沙坦/氨氯平地片组,急性冠脉综合征、卒中事件发生率高于缬沙坦/氨氯平地片组。结论不同新型单片复方制剂干预高血压心脏病患者预后机制不同,应根据患者具体危险因素进行合理的个体化治疗。

Objective The aim of this study is to discuss the implication of different single pill combination antihyperten- sive therapies for the prognosis of hypertensive heart disease. Methods 161 patients who were diagnosed with hypertensive heart disease were selected randomly and divided into two groups. One group was treated by valsartan/amlodiplne 80mg/Smg qd and the other was treated by valsartan/hydrochlorothiazide 80mg/12. 5rag qd. Blood pressure target achievements, incidences of adverse effect and ineidenees of primary efficacy endpoints （ heart failure, acute coronary syndrome, stroke） of these two groups were com- pared after 2 years in order to detect whether the differences between two groups have statistical significance. Results The differ- ences between the two groups of blood pressure target achievements and incidences of adverse effect had no statistical significance （ P 〉 0. 05 ） , and the difference between the two groups of incidences of primary efficacy endpoints had statistical significance （ P 〈 0. 05）. The incidence of heart failure of valsartan/amlodipine group was lower than, but the incidences of ACS and stroke were higher than valsartardhydrochlorothiazide group. Conclusion The mechanisms of different single pill combination antihypertensive therapies in intervening hypertensive heart disease were different. Reasonable individual therapy should be given according to patient＇s hazards.