美托洛尔联合厄贝沙坦治疗老年高血压的临床效果探讨

Clinical efficacy of metoprolol combined with irbesartan in the treatment of hypertension in the elderly

目的探讨美托洛尔联合厄贝沙坦治疗老年高血压的临床效果。方法120例老年高血压患者,随机分为二联降压组和单一降压组,每组60例。单一降压组应用厄贝沙坦治疗,二联降压组在单一降压组基础上增加美托洛尔治疗。比较两组血压水平、血压达标率、生活质量评分、不良反应发生率。结果二联降压组治疗1、2、3个月后收缩压(140.03±14.25)、(135.71±15.72)、(133.24±12.02)mm Hg(1 mm Hg=0.133 kPa)和舒张压(86.25±5.37)、(84.69±4.52)、(82.36±5.62)mm Hg显著低于单一降压组的(150.71±13.85)、(145.02±14.13)、(138.52±14.78)mm Hg和(91.39±6.87)、(87.25±5.37)、(85.19±4.98)mm Hg(P<0.05)。二联降压组治疗1、2、3个月后血压达标率分别为63.33%、76.67%、93.33%,均显著高于单一降压组的41.67%、58.33%、78.33%(P<0.05)。二联降压组治疗后健康调查简表(SF-36)中生理功能、情感职能、生理职能、社会功能、精神健康、精力评分及总分均显著高于单一降压组(P<0.05)。二联降压组不良反应发生率11.67%(7/60)与单一降压组的8.33%(5/60)比较,差异无统计学意义(P>0.05)。结论在厄贝沙坦降压治疗基础上联合美托洛尔协同治疗,可有效降低老年高血压患者的血压水平,提高血压达标率、生活质量,安全性高,预后良好。

Objective To explore the clinical effect of metoprolol combined with irbesartan in the treatment of hypertension in the elderly.Methods 120 elderly patients with hypertension were randomly divided into a dual antihypertensive group and a single antihypertensive group,with 60 patients in each group.The single antihypertensive group was treated with irbesartan,and the dual antihypertensive group was treated with metoprolol on the basis of the single antihypertensive group.The blood pressure level,blood pressure compliance rate,quality of life score and incidence of adverse reactions were compared between the two groups.Results After 1,2 and 3 months of treatment,the systolic blood pressure of the dual antihypertensive group were(140.03±14.25),(135.71±15.72),(133.24±12.02)mm Hg(1 mm Hg=0.133 kPa),and the diastolic blood pressure were(86.25±5.37),(84.69±4.52),(82.36±5.62)mm Hg,which were significantly lower than(150.71±13.85),(145.02±14.13),(138.52±14.78)mm Hg and(91.39±6.87),(87.25±5.37),(85.19±4.98)mm Hg in the single antihypertensive group(P<0.05).After 1,2 and 3 months of treatment,the blood pressure compliance rate of the dual antihypertensive group were 63.33%,76.67% and 93.33%,which were significantly higher than 41.67%,58.33% and 78.33% of the single antihypertensive group(P<0.05).After treatment,the scores of physical function,role-emotional,physical function,social function,mental health,energy and total score in 36-item short-form health survey(SF-36)in the dual antihypertensive group were significantly higher than those in the single antihypertensive group(P<0.05).There was no significant difference in the incidence of adverse reactions between the dual antihypertensive group and the single antihypertensive group[11.67%(7/60)vs 8.33%(5/60)](P>0.05).Conclusion Combined treatment with metoprolol on the basis of irbesartan antihypertensive therapy can effectively reduce the blood pressure level in elderly patients with hypertension,improve the blood pressure compliance rate,quality of life,and it has high safety and good prognosis.