目的 探讨缬沙坦联合氨氯地平不同用药方式和服药时间,治疗原发性高血压的疗效。方法 201例原发性高血压患者(男92例,女109例),接受缬沙坦(80 mg/d)联合氨氯地平(5 mg/d)治疗,随机分为四组,各组治疗方案如下:A组两种药物均于清晨服用,B组两种药物均于睡前服用,C组缬沙坦清晨服用、氨氯地平睡前服用,D组氨氯地平清晨服用、缬沙坦睡前服用。监测各组服药前及服药后12周的24 h动态血压值。结果 服药12周后,各组血压指标均较治疗前下降,差异有统计学意义(P＜0.05)。B组服药后各血压指标下降幅度明显低于其他三组,其中24 h SBP/DBP平均值分别为A组(123.0±13.2)mmHg/(73.1±6.7)mmHg、B组(113.6±11.0)mmHg/(67.1±8.3)mmHg、C组(124.4±13.7)mmHg/(73.6±9.0)mmHg、D组(119.8±13.0)mmHg/(70.6±7.2)mmHg,差异有统计学意义(P<0.01)。结论 缬沙坦与氨氯地平睡前联合服用,治疗原发性高血压的效果最佳。
Abstract
Objective To investigate the clinical efficacy of valsartan / amlodipine combination and different time of taking medicine in treatment of essential hypertension. Methods 201 essential hypertensive subjects (92 men/109 women), were recruited randomized to receive valsartan(80 mg/day) and amlodipine (5 mg/day) in one of the following four therapeutic schemes: both medications on awakening, both at bedtime, either one administered on awakening and the other at bedtime. BP was measured by ambulatory monitoring for 24 consecutive hours before and after 12 wks of treatment. Results BP-lowering efficacy (quantified in terms of reduction of the 24-h mean of systolic/diastolic BP) was highest when both antihypertensive medicines were ingested at bedtime, as compared with any one of the three other tested therapeutic schemes[A(123.0±13.2)mmHg/(73.1±6.7)mmHg、B(113.6±11.0)mmHg/(67.1±8.3)mmHg、C(124.4±13.7)mmHg/(73.6±9.0)mmHg、D(119.8±13.0)mmHg/(70.6±7.2)mmHg,P<0.01]. Conclusions The greater proportion of controlled patients, improved efficacy on lowering asleep BP mean, and increased sleep-time relative BP decline suggest that valsartan/amlodipine combination therapy should be preferably administered at bedtime.
关键词
缬沙坦 /
氨氯地平 /
原发性高血压 /
联合用药
Key words
valsartan /
amlodipine /
essential hypertension /
combination therapy
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