对于仅使用氨氯地平血压控制不佳的高血压患者，加用缬沙坦比加用氯沙坦更有效。

Valsartan addition to amlodipine is more effective than losartan addition in hypertensive patients inadequately controlled by amlodipine.

作者信息

Fogari Roberto, Mugellini Amedeo, Preti Paola, Zoppi Annalisa, Derosa Giuseppe

机构信息

Department of Internal Medicine and Therapeutics, Centro Ipertensione e Fisiopatologia Cardiovascolare, University of Pavia, Pavia, Italy.

出版信息

Vasc Health Risk Manag. 2010 Mar 3;6:87-93. doi: 10.2147/vhrm.s9404.

DOI:10.2147/vhrm.s9404

PMID:20234783

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2835558/

Abstract

INTRODUCTION

This study evaluated the effects on blood pressure (BP) of valsartan 160 mg or losartan 100 mg addition to amlodipine 5 mg in hypertensive patients.

METHODS

221 patients with inadequately controlled BP (DBP >or= 90 mmHg) after 4 weeks of treatment with amlodipine 5 mg were randomized to receive losartan/amlodipine combination therapy or valsartan/amlodipine combination therapy for 4 weeks in a cross-over study design. At the end of the wash-out period and of each treatment period, clinic and ambulatory BP measurements were recorded.

RESULTS

166 patients completed the study. Both combination treatments induced a greater ambulatory BP reduction than did monotherapy. However, the further mean reductions in BP versus monotherapy were significantly greater with the valsartan/amlodipine combination (SBP/DBP: -7.9 +/- 3.4/-6.5 +/- 2.6 mmHg for 24-hour, -8.0 +/- 3.4/-6.6 +/- 2.7 mmHg for daytime; -7.7 +/- 3.3/-6.4 +/- 2.7 mmHg for nighttime) than with the losartan/amlodipine combination (SBP/DBP: -5.5 +/- 2.8/-4.2 +/- 2.1 mmHg for 24-hour, -5.7 +/- 2.9/-4.4 +/- 2.2 mmHg for daytime; -4.8 +/- 2.8/-3.7 +/- 2.2 mmHg for nighttime; P < 0.01 vs valsartan/amlodipine). The incidence of adverse events with valsartan/amlodipine (8%) and losartan/amlodipine (9%) was lower than that observed with amlodipine monotherapy (17%; P < 0.05 vs combinations).

CONCLUSION

Valsartan 160 mg plus amlodipine 5 mg produced greater BP reductions than losartan 100 mg plus amlodipine 5 mg.

摘要

引言

本研究评估了在高血压患者中，缬沙坦160毫克或氯沙坦100毫克联合氨氯地平5毫克对血压（BP）的影响。

方法

在一项交叉研究设计中，221例接受氨氯地平5毫克治疗4周后血压控制不佳（舒张压≥90毫米汞柱）的患者被随机分为接受氯沙坦/氨氯地平联合治疗或缬沙坦/氨氯地平联合治疗4周。在洗脱期结束时和每个治疗期结束时，记录临床和动态血压测量值。

结果

166例患者完成了研究。两种联合治疗均比单一疗法导致更大幅度的动态血压降低。然而，与氯沙坦/氨氯地平联合治疗相比，缬沙坦/氨氯地平联合治疗使血压相对于单一疗法的进一步平均降低幅度更大（24小时收缩压/舒张压：-7.9±3.4/-6.5±2.6毫米汞柱，白天：-8.0±3.4/-6.6±2.7毫米汞柱；夜间：-7.7±3.3/-6.4±2.7毫米汞柱），氯沙坦/氨氯地平联合治疗（24小时收缩压/舒张压：-5.5±2.8/-4.2±2.1毫米汞柱，白天：-5.7±2.9/-4.4±2.2毫米汞柱；夜间：-4.8±2.8/-3.7±2.2毫米汞柱；与缬沙坦/氨氯地平联合治疗相比，P<0.01）。缬沙坦/氨氯地平联合治疗（8%）和氯沙坦/氨氯地平联合治疗（9%）的不良事件发生率低于氨氯地平单一疗法（17%；与联合治疗相比，P<0.05）。