Ke Yong-Sheng, Tao Yue-Yu, Yang Hao, Yu Guo-Hua
Department of Cardiology, Yijishan Hospital, Wannan Medical College, Wuhu 241001, China.
Acta Pharmacol Sin. 2003 Apr;24(4):337-41.
To evaluate the effects of valsartan (Val) with or without benazepril (Ben) on blood pressure and plasma levels of angiotensin (Ang II) and digoxin-immunoreactive factors (endoxin) in patients with essential hypertension.
Ninety patients with essential hypertension were randomly divided into 3 groups (n=30 per group): Ben group (Ben 10 mg/d, po); Val group (Val 80 mg/d, po); combination drug therapy group (Val 80 mg/d+Ben 10 mg/d, po); all patients were treated for 12 weeks. Age and sex-matched 20 normal subjects were served as control group.
The levels of plasma endoxin and Ang II in patients with essential hypertension were remarkably higher than those in normal subjects. The levels of plasma Ang II and endoxin were all obvious positive correlation with systolic blood pressure (SBP) and diastolic blood pressure (DBP) (Ang II: r=0.5151, 0.7978; endoxin: r=0.4706, 0.7274, respectively). Within 6 weeks of drug intervene, SBP and DBP were remarkably decreased in 3 groups. After 6 weeks, SBP and DBP were continuously decreased in Ben group and Val+Ben group, but not in Val group. Level of plasma Ang II was remarkably decreased as SBP and DBP decreased in Ben group and Val+Ben group; level of plasma Ang II was remarkably increased in Val group.
Val with or without Ben remarkably decreased SBP and DBP in patients with essential hypertension within 6 weeks. Antihypertensive efficacy was weakened after long-term use of Val alone. The antihypertensive effect of Val+Ben group was the most remarkable among 3 groups and could avoid the side effects of high plasma Ang II.
评估缬沙坦(Val)单用或联合苯那普利(Ben)对原发性高血压患者血压、血浆血管紧张素(Ang II)水平及地高辛免疫反应因子(内毒素)的影响。
90例原发性高血压患者随机分为3组(每组n = 30):苯那普利组(苯那普利10 mg/d,口服);缬沙坦组(缬沙坦80 mg/d,口服);联合药物治疗组(缬沙坦80 mg/d + 苯那普利10 mg/d,口服);所有患者均治疗12周。选取年龄和性别匹配的20例正常受试者作为对照组。
原发性高血压患者血浆内毒素和Ang II水平显著高于正常受试者。血浆Ang II和内毒素水平与收缩压(SBP)和舒张压(DBP)均呈明显正相关(Ang II:r = 0.5151,0.7978;内毒素:r = 0.4706,0.7274)。药物干预6周内,3组患者的SBP和DBP均显著下降。6周后,苯那普利组和缬沙坦 + 苯那普利组的SBP和DBP持续下降,但缬沙坦组未下降。苯那普利组和缬沙坦 + 苯那普利组中,随着SBP和DBP下降,血浆Ang II水平显著降低;缬沙坦组血浆Ang II水平显著升高。
缬沙坦单用或联合苯那普利在6周内可显著降低原发性高血压患者的SBP和DBP。长期单用缬沙坦后降压疗效减弱。缬沙坦 + 苯那普利组在3组中降压效果最显著,且可避免血浆Ang II升高带来的副作用。