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奥美沙坦/氨氯地平联合治疗轻至重度高血压患者的疗效和耐受性:聚焦24小时血压控制

Efficacy and tolerability of olmesartan/amlodipine combination therapy in patients with mild-to-severe hypertension: focus on 24-h blood pressure control.

作者信息

Parati Gianfranco, Ochoa Juan Eugenio, Ramos Carlos, Hoshide Satoshi, Lonati Laura, Bilo Grzegorz

机构信息

Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Department of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico Italiano, via Spagnoletto, 3 20149 Milan, Italy.

出版信息

Ther Adv Cardiovasc Dis. 2010 Oct;4(5):301-13. doi: 10.1177/1753944710380228.

Abstract

European guidelines recommend that treating patients with hypertension to blood pressure (BP) goal is an important target for cardiovascular (CV) risk reduction. However, office BP may be a suboptimal target, given its limitations. Indeed, there is evidence that 24-h ambulatory BP monitoring (ABPM) parameters may score better in this regard, representing more accurate predictors of CV risk. In particular, mean 24-h BP and BP variability both correlate closely with hypertension end-organ damage and rate of CV events, which suggests that antihypertensive therapy should provide smooth BP control over the full 24-h dosing interval. The use of ABPM has demonstrated that fixed-dose combination therapy, comprising agents with complementary mechanisms of action, may overcome the challenge of suboptimal BP control by providing improvements in antihypertensive efficacy and tolerability throughout the 24-h period. Olmesartan/amlodipine is one of the latest combination therapies to be approved, and a number of large clinical trials have demonstrated the efficacy and tolerability of this combination in patients with mild-to-severe hypertension. Furthermore, recent ABPM studies of olmesartan/amlodipine-based treatment algorithms have shown the satisfactory 24-h antihypertensive efficacy of this fixed-dose combination. This review provides an overview of recent clinical data on the efficacy and tolerability of fixed-dose olmesartan/amlodipine combination therapy for the treatment of mild-to-severe hypertension, with a focus on sustained 24-h BP control.

摘要

欧洲指南建议,将高血压患者的血压控制在目标范围内是降低心血管(CV)风险的重要目标。然而,鉴于诊室血压存在局限性,它可能并非理想的目标。事实上,有证据表明,24小时动态血压监测(ABPM)参数在这方面可能表现更佳,是心血管风险更准确的预测指标。特别是,24小时平均血压和血压变异性均与高血压靶器官损害及心血管事件发生率密切相关,这表明抗高血压治疗应在整个24小时给药间隔内实现平稳的血压控制。使用ABPM已证明,由作用机制互补的药物组成的固定剂量联合治疗,可通过在24小时内提高抗高血压疗效和耐受性来克服血压控制不佳的挑战。奥美沙坦/氨氯地平是最新获批的联合治疗方案之一,多项大型临床试验已证明该联合用药对轻至重度高血压患者的疗效和耐受性。此外,最近基于奥美沙坦/氨氯地平治疗方案的ABPM研究表明,这种固定剂量联合用药具有令人满意的24小时抗高血压疗效。本综述概述了固定剂量奥美沙坦/氨氯地平联合治疗轻至重度高血压的疗效和耐受性的最新临床数据,重点关注24小时持续血压控制。

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