Conter Howard S, McKay Donald W, Reiz Ruby J Shanlin
MSHJ Research Associates, Halifax, Nova Scotia.
Can J Cardiol. 2004 Oct;20 Suppl C:6C-10C.
Evidence suggests that antihypertensive agents may have differential effects on systolic blood pressure (SBP) and that home BP monitoring (HBPM) may enhance the antihypertensive effects.
To evaluate the efficacy and safety of eprosartan mesylate in the treatment of hypertension, particularly on SBP in older subjects, and to assess the role of HBPM.
A randomized, open-label, 10-week study was conducted in 35 primary care centres across Canada. One hundred ninety-eight subjects (aged 60 to 84 years) with mild to moderate hypertension (SBP 140 mmHg to 179 mmHg, diastolic BP [DBP] 109 mmHg or less) were included in the analysis. All subjects received open-label eprosartan mesylate 600 mg once daily, and were randomly assigned to eprosartan treatment alone or eprosartan plus HBPM. Hydrochlorothiazide 12.5 mg once daily could be added after week 4. The primary outcomes were the change in SBP at study end and the effect of HBPM on SBP.
In the eprosartan and eprosartan plus HBPM groups, SBP was reduced by 17.6 mmHg and 19.9 mmHg, and DBP was reduced by 8.7 mmHg and 8.5 mmHg, with a systolic pressure response of 58% and 65%, respectively. HBPM had no additional benefits. Eprosartan was well tolerated, with the majority of adverse events being mild to moderate.
Eprosartan alone or in combination with hydrochlorothiazide was highly effective and safe in lowering blood pressure, notably SBP, in older subjects with mild to moderate hypertension.
有证据表明,抗高血压药物对收缩压(SBP)可能有不同的作用,并且家庭血压监测(HBPM)可能会增强降压效果。
评估甲磺酸依普罗沙坦治疗高血压的疗效和安全性,特别是对老年受试者收缩压的影响,并评估家庭血压监测的作用。
在加拿大全国35个初级保健中心进行了一项随机、开放标签、为期10周的研究。198名年龄在60至84岁之间的轻度至中度高血压患者(收缩压140 mmHg至179 mmHg,舒张压[DBP]109 mmHg或更低)纳入分析。所有受试者均接受开放标签的甲磺酸依普罗沙坦,每日一次,每次600 mg,并随机分为单独使用依普罗沙坦治疗组或依普罗沙坦加家庭血压监测组。第4周后可加用氢氯噻嗪,每日一次,每次12.5 mg。主要结局为研究结束时收缩压的变化以及家庭血压监测对收缩压的影响。
在依普罗沙坦组和依普罗沙坦加家庭血压监测组中,收缩压分别降低了17.6 mmHg和19.9 mmHg,舒张压分别降低了8.7 mmHg和8.5 mmHg,收缩压反应率分别为58%和65%。家庭血压监测没有额外的益处。依普罗沙坦耐受性良好,大多数不良事件为轻度至中度。
单独使用依普罗沙坦或与氢氯噻嗪联合使用,在降低轻度至中度高血压老年受试者的血压(尤其是收缩压)方面非常有效且安全。