缬沙坦氨氯地平联合阿托伐他汀治疗老年顽固性单纯收缩期高血压的临床研究

Clinical study of valsartan and amlodipine combined with atorvastatin in the treatment of isolated systolic resistant hypertension in the elderly

目的探究缬沙坦氨氯地平联合阿托伐他汀治疗老年顽固性单纯收缩期高血压的临床效果。方法64例老年顽固性单纯收缩期高血压患者为研究对象,依据随机抽签法分为对照组和观察组,各32例。对照组采用缬沙坦氨氯地平治疗,观察组采用缬沙坦氨氯地平联合阿托伐他汀治疗。比较两组治疗效果,治疗前后血压水平及心脏超声指标[舒张末期室间隔厚度(IVST)、左室后壁厚度(PWT)、左室舒张末期内径(LVEDd)],不良反应发生情况。结果观察组治疗总有效率96.88%显著高于对照组的81.25%,差异有统计学意义(P<0.05)。治疗6个月后,观察组的收缩压(121.09±9.02)mmHg(1mm Hg=0.133 kPa)、IVST(8.31±1.00)mm、PWT(9.06±0.95)mm、LVEDd(51.19±1.77)mm均显著低于对照组的(134.47±9.57)mm Hg、(9.00±0.95)mm、(9.91±0.89)mm、(52.47±1.85)mm,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论缬沙坦氨氯地平联合阿托伐他汀治疗老年顽固性单纯收缩期高血压效果显著,可显著降低患者的收缩压水平,并有助于改善心室肥厚,对于改善患者预后具有积极的意义,值得推广应用。

Objective To investigate the clinical effect of valsartan and amlodipine combined with atorvastatin in the treatment of isolated systolic resistant hypertension in the elderly.Methods A total of 64 elderly patients with isolated systolic resistant hypertension were divided into control group and observation group according to random lottery method,with 32 cases in each group.The control group was treated with valsartan and amlodipine,and the observation group was treated with valsartan and amlodipine in combination with atorvastatin.Both groups were compared in terms of therapeutic effect,blood pressure level and cardiac ultrasound index[interventricular septal thickness(IVST),posterior wall thickness(PWT),left ventricular end-diastolic diameter(LVEDd)]before and after treatment,and the occurrence of adverse reaction.Results The total effective rate of the observation group was 96.88%,which was significantly higher than that of 81.25%of the control group,and the difference was statistically significant(P<0.05).6 months after treatment,the observation group had systolic blood pressure of(121.09±9.02)mm Hg(1 mm Hg=0.133 kPa),IVST of(8.31±1.00)mm,PWT of(9.06±0.95)mm and LVEDd of(51.19±1.77)mm,which were significantly lower than those of(134.47±9.57)mm Hg,(9.00±0.95)mm,(9.91±0.89)mm,and(52.47±1.85)mm in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Valsartan and amlodipine combined with atorvastatin has a significant effect in the treatment of isolated systolic resistant hypertension in the elderly.It can significantly reduce the systolic blood pressure,and help to improve ventricular hypertrophy.It has positive significance in improving the prognosis of patients,and is worthy of popularization and application.