Julius Stevo, Cohn Jay N, Neutel Joel, Weber Michael, Turlapaty Prasad, Shen Yannan, Dong Victor, Batchelor Alicia, Lagast Hjalmar
Division of Hypertension, University of Michigan, Ann Arbor, MI 48109, USA.
J Clin Hypertens (Greenwich). 2004 Jan;6(1):10-7. doi: 10.1111/j.1524-6175.2004.02440.x.
The authors evaluated, in a community-based open-label trial, the effectiveness and safety of perindopril in 13,220 US hypertensive patients and studied how physicians adhere to hypertension treatment guidelines. Patients received perindopril 4 mg q.d. for 6 weeks. Based on physicians perception of blood pressure response, the patient was either maintained on 4 mg or the dose was increased to 8 mg for an additional 6 weeks. From baseline to week 12, the mean sitting blood pressure significantly declined from 156.9/94.5 mm Hg to 139.2/84.0 mm Hg. Further dose titration resulted in a clinically significant reduction in blood pressure in all patients with inadequate response on 4 mg at week 6. Blood pressure control (<140/<90 mm Hg) was achieved at 12 weeks in 48.8% patients. The subpopulation analyses demonstrated that perindopril monotherapy was effective in both men and women, in patients of all ethnicities, and in patients <65 and > or =65 years of age. Perindopril was safe and well tolerated in all hypertensive subgroups including high-risk patients. Physicians were more attuned to controlling diastolic than systolic blood pressure, and their adherence to the treatment guidelines was found to be not optimal.
作者在一项基于社区的开放标签试验中，评估了培哚普利对13220名美国高血压患者的有效性和安全性，并研究了医生对高血压治疗指南的遵循情况。患者接受培哚普利4毫克每日一次，共6周。根据医生对血压反应的判断，患者要么维持4毫克剂量，要么将剂量增加到8毫克，再持续6周。从基线到第12周，平均坐位血压从156.9/94.5毫米汞柱显著降至139.2/84.0毫米汞柱。进一步的剂量滴定使所有在第6周对4毫克剂量反应不足的患者血压出现临床上的显著降低。12周时，48.8%的患者实现了血压控制（<140/<90毫米汞柱）。亚组分析表明，培哚普利单药治疗对男性和女性、所有种族的患者以及年龄<65岁和≥65岁的患者均有效。培哚普利在包括高危患者在内的所有高血压亚组中均安全且耐受性良好。医生更关注控制舒张压而非收缩压，且发现他们对治疗指南的遵循情况并不理想。
