老年高血压患者降压降脂是否加用阿司匹林

Is it necessary to add aspirin to antihypertension and lipid-lowering therapy in senile hypertensive patients

目的观察高血压伴血脂升高的老年患者在降压降脂基础上是否加用阿司匹林对预防心脑血管并发症的影响。方法 260例原发性高血压伴血脂升高的老年患者,随机分为A组及B组,每组130例。A组给予降压降脂治疗,未加用阿司匹林;B组在降压降脂基础上加用阿司匹林。比较两组患者的治疗效果。结果两组组间治疗前后的收缩压、舒张压、低密度脂蛋白胆固醇(LDL-C)水平比较,差异均无统计学意义(P>0.05);两组组内治疗前后的收缩压、舒张压、LDL-C水平比较,差异均具有统计学意义(P<0.05)。两组患者心绞痛及脑梗死发生率比较,差异无统计学意义(χ~2=0.07,P>0.05)。两组患者改用降压药情况比较,差异无统计学意义(χ~2=0.223,P>0.05)。两组患者服用辛伐他汀未达标情况比较,差异无统计学意义(χ~2=0.053,P>0.05)。结论高血压伴血脂升高的老年患者仅服用降压药、降脂药就可以达到预防心绞痛、脑梗死等心脑血管并发症的目的 ,不需要加用阿司匹林。

Objective To observe the effect of adding aspirin to antihypertension and lipid-lowering therapy on prevention of cardiovascular and cerebrovascular complications in senile patients with essential hypertension and hyperlipidemia. Methods A total of 260 senile patients with essential hypertension and hyperlipidemia were randomly divided into group A and group B, with 130 cases in each group. Group A received antihypertension and lipid-lowering therapy without aspirin, and group B received aspirin on the basis of antihypertension and lipid-lowering therapy. Treatment effect in two groups was compared. Results Both groups had no statistically significant difference in systolic blood pressure, diastolic blood pressure, and low-density lipoprotein cholesterol （LDL-C） before and after treatment （P〉0.05）. Both groups had statistically significant difference in systolic blood pressure, diastolic blood pressure, and LDL-C level before and after treatment （P〈0.05）.Both groups had no statistically significant difference in incidence of angina and cerebral infarction （X2=0.07, P〉0.05）. Both groups had no statistically significant difference in switching to antihypertensive drugs situation （X2=0.223, P〉0.05）. Both groups had no statistically significant difference in taking simvastatin not up to standard （X2=0.053, P〉0.05）. Conclusion Senile patients with essential hypertension and hyperlipidemia can achieve the purpose of preventing angina and cerebral infarction by taking antihypertensive drugs and lipid-lowering drugs only. Aspirin is not required.