调脂对老年肥胖高血压患者降压治疗效果及动脉硬化的影响

Effect of lipid-lowering therapy on blood pressure and arteriosclerosis in elderly obesity hypertension patients

目的探讨调脂对不同肥胖类型老年高血压患者降压疗效及动脉硬化的影响。方法从老年体检者中选择322例原发性高血压患者按照析因设计随机分为4组:调脂降压腹型肥胖组(A组)89例、调脂降压非腹型肥胖组(B组)75例、单纯降压腹型肥胖组(C组)87例、单纯降压非腹型肥胖组(D组)71例。各组均给予替米沙坦40mg/d,调脂降压治疗在此基础上给予瑞舒伐他汀10mg/d,为期6个月。结果 A、B、C和D组治疗后,收缩压、舒张压、体质量指数、腰围、TG、TC、空腹血糖、踝肱指数(ABI,0.90±0.15 vs 0.92±0.14 vs 0.85±0.14 vs 0.86±0.17)、心-踝血管指数(CAVI,7.62±0.73 vs 7.74±0.74 vs 8.11±0.76 vs 8.30±0.70)比较,差异均有统计学意义(P<0.05)。A、B、C和D组降压有效率比较,差异均有统计学意义(87.64%vs 92.00%vs 78.00%vs 83.10%,P<0.05)。CAVI与收缩压、脉压、TC、TG呈正相关(r=0.180,r=0.153,r=0.895,r=0.533,P<0.01),ABI与收缩压、舒张压呈正相关(r=0.415,r=0.123,P<0.05)。结论调脂对老年肥胖高血压患者降压疗效显著,有效改善动脉硬化症状,且无明显不良反应。

Objective To study the effect of lipid-lowering therapy on blood pressure and arteriosclerosis in elderly obesity hypertension patients.Methods Three hundred and twenty-two patients with essential hypertension were randomly divided into abdominal obesity group（group A,n=89）,non-abdominal obesity group（group B,n=75）,simple abdominal obesity group（group C,n=87）and simple non-abdominal obesity group（group D,n=71）.The patients were treated with telmisartan（40 mg/d）and rosuvastatin（10 mg/d）for 6 months.Results A significant difference was found in SBP,DBP and BMI,waist circumference,serum TG,TC and FBG levels,ABI（0.90±0.15 vs 0.92±0.14 vs 0.85±0.14 vs 0.86±0.17）and CAVI（7.62±0.73 vs 7.74±0.74 vs 8.11±0.76 vs 8.30±0.70）in groups A-D（P〈0.05）.The effective antihypertension rate of lipid-lowering therapy was 87.64%,92.00%,78.00%and 83.10%respectively in groups A-D（P〈0.05）.The CAVI was positively related with SBP,pulse pressure,serum TC and TG level（r=0.180,r=0.153,r=0.895,r=0.533,P〈0.01）.The ABI was positively related with SBP and DBP（r=0.415,r=0.123,P〈0.05）.Conclusion Lipid-lowering therapy can effectively alleviate the symptoms of hypertension and atherosclerosis with no severe adverse reactions.