Oparil Suzanne, Chrysant Steven G, Kereiakes Dean, Xu Jianbo, Chavanu Kathleen J, Waverczak William, Dubiel Robert
Division of Cardiovascular Diseases, University of Alabama at Birmingham School of Medicine, AL, USA.
J Clin Hypertens (Greenwich). 2008 Dec;10(12):911-21. doi: 10.1111/j.1751-7176.2008.00045.x.
The efficacy and safety of an olmesartan medoxomil (OM)-based treatment algorithm was tested in a double-blind, randomized, placebo-controlled titration study in 276 patients with stage 1 or 2 hypertension. After placebo run-in, patients were randomized to placebo (12 weeks) or OM 20 mg/d (weeks 1-3). OM was up-titrated to 40 mg/d (weeks 4-6), then OM/hydrochlorothiazide (HCTZ) 40/12.5 mg/d (weeks 7-9) and OM/HCTZ 40/25 mg/d (weeks 10-12) were started if blood pressure (BP) remained > or =120/80 mm Hg at each time interval. End points were change from baseline in mean systolic BP (primary) and mean diastolic BP (secondary). OM-based treatment was well tolerated and changed BP by -22.3/-12.1 mm Hg from baseline vs -0.1/+0.8 mm Hg for placebo (P<.0001). Cumulative goal BP (<140/90 mm Hg) was achieved in 74.1% and 30.7% of OM- compared with placebo-treated patients, respectively (P<.0001). BP normalized (<120/80 mm Hg) in 44.8% of OM- vs 1.4% of placebo-treated patients with stage 1 hypertension (P<.0001).
在一项针对276例1或2期高血压患者的双盲、随机、安慰剂对照滴定研究中,测试了基于奥美沙坦酯(OM)的治疗方案的疗效和安全性。在安慰剂导入期后,患者被随机分为接受安慰剂治疗(12周)或OM 20 mg/d治疗(第1 - 3周)。若在每个时间间隔血压(BP)仍≥120/80 mmHg,则将OM剂量上调至40 mg/d(第4 - 6周),然后开始使用OM/氢氯噻嗪(HCTZ)40/12.5 mg/d(第7 - 9周)和OM/HCTZ 40/25 mg/d(第10 - 12周)。终点指标为平均收缩压相对于基线的变化(主要指标)和平均舒张压相对于基线的变化(次要指标)。基于OM的治疗耐受性良好,与安慰剂相比,血压从基线下降了-22.3/-12.1 mmHg,而安慰剂组为-0.1/+0.8 mmHg(P<0.0001)。与安慰剂治疗的患者相比,接受OM治疗的患者累积达到目标血压(<140/90 mmHg)的比例分别为74.1%和30.7%(P<0.0001)。在1期高血压患者中,接受OM治疗的患者血压正常化(<120/80 mmHg)的比例为44.8%,而接受安慰剂治疗的患者为1.4%(P<0.0001)。