Fernández-Vega Francisco, Abellán José, Vegazo Onofre, De Vinuesa Soledad García, Rodríguez José Carlos, Maceira Benito, de Castro Saturnino Sanz, Nicolás Roberto Robles, Luño José
Department of Nephrology-I, Hospital Central de Asturias, Spain.
Kidney Int Suppl. 2002 Dec(82):S36-41. doi: 10.1046/j.1523-1755.62.s82.8.x.
Hypertension is twice as common in postmenopausal than in premenopausal women. This study evaluated the effectiveness of a blockade of the renin-angiotensin-aldosterone system (RAAS) with candesartan cilexetil (CC) to control blood pressure (BP) in hypertensive menopausal women, and the influence of hormone replacement therapy (HRT).
This was designed as a prospective, open-label and non-comparative study. Included were 618 hypertensive menopausal women grade I/II according to the Sixth Report of the Joint National Committee (VI-JNC), with an average age 52+/-4.7 years (95% CI 52.3-53.0) and with a last menstrual period (LMP) at least one year before. BP was determined by measurement in four visits during six months of follow-up, according to the recommendations of the OMS/SIH. Optimal control of BP was considered as BP <140/90 mm Hg.
A statistically significant decrease in systolic (SBP; 19.9+/-11.2) and diastolic (DBP; 11.5+/-7.3) blood pressure mm Hg values was observed (P<0.01). The control of BP increased significantly over time to 61.2% (P<0.01). In multivariate analysis, only age was associated with control of BP (beta= -0.062; P=0.004). Of the women not controlled in the second visit, 12.5 mg of hydrochlorothiazide (HCTZ) were added to 31.5% (N=122), with 80% more BP control achieved in visit 3 than in the non-supplement group (OR=1.8; 95% CI 1.04-3.05; P<0.03). One hundred and three (16.7%) patients were receiving HRT for 2.01+/-2.23 years (95% CI 1.55-2.46). HRT did not affect the control of BP. No severe adverse reactions were reported.
Candesartan cilexetil significantly reduced SBP and DBP and increased control (61.2%) of BP in hypertensive menopausal women. Only age had an inverse association with control of BP. In this study, HRT did not affect the control of BP.
绝经后女性患高血压的几率是绝经前女性的两倍。本研究评估了坎地沙坦酯（CC）阻断肾素 - 血管紧张素 - 醛固酮系统（RAAS）对控制绝经后高血压女性血压（BP）的有效性，以及激素替代疗法（HRT）的影响。
本研究设计为前瞻性、开放标签且非对照研究。纳入了618名根据美国国家联合委员会第六次报告（VI - JNC）分级为I/II级的绝经后高血压女性，平均年龄52±4.7岁（95%可信区间52.3 - 53.0），且末次月经（LMP）至少在一年前。根据世界卫生组织/国际高血压学会（OMS/SIH）的建议，在随访的6个月内分4次测量血压。血压的最佳控制定义为血压<140/90 mmHg。
观察到收缩压（SBP；19.9±11.2）和舒张压（DBP；11.5±7.3）mmHg值有统计学意义的下降（P<0.01）。血压控制率随时间显著增加至61.2%（P<0.01）。在多变量分析中，只有年龄与血压控制相关（β = -0.062；P = 0.004）。在第二次就诊时血压未得到控制的女性中，31.5%（N = 122）加用了12.5 mg氢氯噻嗪（HCTZ），第三次就诊时血压控制情况比未补充组多80%（比值比=1.8；95%可信区间1.04 - 3.05；P<0.03）。103名（16.7%）患者接受HRT治疗2.01±2.23年（95%可信区间1.55 - 2.46）。HRT对血压控制无影响。未报告严重不良反应。
坎地沙坦酯显著降低了绝经后高血压女性的收缩压和舒张压，并提高了血压控制率（61.2%）。只有年龄与血压控制呈负相关。在本研究中，HRT对血压控制无影响。
