抗高血压药物联合治疗对高血压患者的有益作用。

Beneficial effect of combination therapy with antihypertensive drugs in patients with hypertension.

作者信息

Shikata Chihiro, Sekikawa Tetsuaki, Kimura Nobuaki, Kojima Akira, Seki Shingo, Oka Hisayoshi, Nishiyama Akihiro, Takeda Nobuakira

机构信息

Department of Internal Medicine, Aoto Hospital, Jikei University School of Medicine.

出版信息

Exp Clin Cardiol. 2007 Spring;12(1):33-6.

PMID:18650977

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2359624/

Abstract

BACKGROUND

Cardiac hypertrophy and failure are major complications of hypertension.

OBJECTIVES

The beneficial effect of treatment with antihypertensive drugs on serum levels of brain natriuretic peptide (BNP) was examined in patients with essential hypertension.

METHODS

Antihypertensive drugs were administered to 88 hypertensive patients (44 diabetic and 44 nondiabetic) whose systolic blood pressure was greater than 140 mmHg and/or diastolic blood pressure was greater than 90 mmHg. Other antihypertensive drugs were added every two months until the blood pressure fell below 130/85 mmHg. Candesartan, benidipine, bisoprolol or celiprolol, and bunazosin were administered in this order.

RESULTS

The mean systolic blood pressure was reduced from 163.7+/-11.6 mmHg to 121.8+/-7.5 mmHg after 12 months in patients with diabetes and from 167.6+/-12.3 mmHg to 122.8+/-7.5 mmHg in patients without diabetes. The mean diastolic blood pressure was also significantly reduced in patients with and without diabetes. Serum BNP levels were reduced from 52.2+/-38.8 pg/mL to 38.8+/-30.9 pg/mL in patients with diabetes and from 47.1+/-34.2 pg/mL to 35.8+/-22.5 pg/mL in patients without diabetes. In patients older than 70 years of age, serum BNP levels were reduced from 56.3+/-39.3 pg/mL to 40.2+/-23.0 pg/mL in those with diabetes and from 54.6+/-32.9 pg/mL to 38.0+/-16.0 pg/mL in those without diabetes.

CONCLUSIONS

These results indicate that combination therapy with antihypertensive drugs is usually necessary to reduce blood pressure to below 130/85 mmHg and to improve serum BNP levels.

摘要

背景

心脏肥大和心力衰竭是高血压的主要并发症。

目的

在原发性高血压患者中，研究抗高血压药物治疗对血清脑钠肽（BNP）水平的有益影响。

方法

对88例高血压患者（44例糖尿病患者和44例非糖尿病患者）进行抗高血压药物治疗，这些患者的收缩压大于140 mmHg和/或舒张压大于90 mmHg。每两个月添加其他抗高血压药物，直到血压降至130/85 mmHg以下。依次给予坎地沙坦、贝尼地平、比索洛尔或塞利洛尔以及布那唑嗪。

结果

糖尿病患者12个月后平均收缩压从163.7±11.6 mmHg降至121.8±7.5 mmHg，非糖尿病患者从167.6±12.3 mmHg降至122.8±7.5 mmHg。糖尿病患者和非糖尿病患者的平均舒张压也显著降低。糖尿病患者血清BNP水平从52.2±38.8 pg/mL降至38.8±30.9 pg/mL，非糖尿病患者从47.1±34.2 pg/mL降至35.8±22.5 pg/mL。在70岁以上的患者中，糖尿病患者血清BNP水平从56.3±39.3 pg/mL降至40.2±23.0 pg/mL，非糖尿病患者从54.6±32.9 pg/mL降至38.0±16.0 pg/mL。