氯沙坦对高血压病人肾素活性的影响

Influence of losartan on plasma renin activity in patients with hypertension

目的 :研究血管紧张肽II受体阻断剂氯沙坦对原发性高血压病人的降压疗效及其对肾素活性水平的影响。方法 :坐位舒张压 12 .7～ 15 .2kPa的原发性高血压病人 36例 ,经 1wk药物洗脱期 ,2wk安慰剂期后服用氯沙坦 5 0mg ,po ,qd ,4wk末坐位舒张压≥ 11.7kPa者剂量加至 10 0mg ,po ,qd× 4wk。服用氯沙坦前后测坐位血压和立位血浆肾素活性水平。结果 :8wk末平均动脉压从 15 .2kPa±1.1kPa下降至 13.7kPa± 1.1kPa(P <0 .0 1)。平均血浆肾素活性水平从 1.5 5 μg·L- 1·h- 1增加至5 .5 4 μg·L- 1·h- 1。结论 :氯沙坦使肾素活性水平增加 。

AIM: To investigate the influence of losartan [angiotensin II (Ang II) receptor blocker] on plasma renin activity(PRA) in hypertensive patients,and effect of blood pressure descent. METHODS: After 1wk washout and 2 wk placebo run-in period, thirty-six patients with diastolic blood pressure 12.7 -15.2 kPa were administrated with losartan 50 mg,po,qd,for 4 wk. Followed by dose titration to 100 mg,po,qd,for another 4 wk in those patients with seated DBP≥ 11.7 kPa. Seated and standing blood pressure, heart rate(HR), and adverse reactions were assessed during placebo period and at the end of 4 wk and 8 wk. PRA were measured after placebo run-in and at the end of wk 8. RESULTS: Mean blood pressure(MBP) in trough decreased from 15.2 kPa± 1.1 kPa to 13.7 kPa± 1.1 kPa and PRA increased from 1.55 μg·L -1·h -1 to 5.54 μg·L -1·h -1 at the end of wk 8. CONCLUSION:Losartan can increase PRA . But there are no clear relations between baseline PRA, the changes of PRA and antihypertensive efficacy.