Department of Cardiology, Fukuoka University School of Medicine, Jonan-ku, Fukuoka, Japan.
J Renin Angiotensin Aldosterone Syst. 2012 Mar;13(1):107-12. doi: 10.1177/1470320311415135. Epub 2011 Jul 11.
Losartan/hydrochlorothiazide (HCTZ) (Preminent®) is a fixed-dose combination of angiotensin II receptor blocker (ARB) and the thiazide diuretic HCTZ that has consistently been shown to be more effective than either losartan or HCTZ. Little is known about the relationship between losartan/HCTZ and blood levels of brain natriuretic peptide (BNP).
In this study, 44 patients with hypertension who were being treated with ARB were enrolled. The ARB was changed to losartan/HCTZ because of uncontrolled hypertension. Blood pressure (BP), pulse rate (PR), plasma levels of BNP and other biochemical parameters were analyzed at baseline and 6 and 12 months after the change from ARB. Of the total 44 patients, 33 (75%) achieved the target BP at 12 months. While there was no significant change in PR, systolic and diastolic BP were significantly reduced (-23 ± 3 mmHg and -10 ± 2 mmHg, respectively) during this period. Although there were no significant changes in biochemical parameters, plasma levels of BNP were significantly decreased, especially in patients who had higher levels of BNP at baseline, during this period.
Losartan/HCTZ therapy significantly reduced not only BP but also plasma levels of BNP in patients with hypertension. These findings suggest that losartan/HCTZ might have cardioprotective effects in patients with higher levels of BNP.
氯沙坦/氢氯噻嗪（HCTZ）（Preminent®）是血管紧张素 II 受体阻滞剂（ARB）和噻嗪类利尿剂 HCTZ 的固定剂量组合，已被证明比氯沙坦或 HCTZ 更有效。关于氯沙坦/HCTZ 与脑利钠肽（BNP）的血药浓度之间的关系知之甚少。
本研究纳入了 44 名正在接受 ARB 治疗的高血压患者。由于高血压未得到控制，将 ARB 更换为氯沙坦/HCTZ。在更换 ARB 之前和之后的 6 个月和 12 个月，分析血压（BP）、脉搏率（PR）、BNP 血浆水平和其他生化参数。在总共 44 名患者中，有 33 名（75%）在 12 个月时达到目标 BP。虽然 PR 没有显著变化，但在此期间收缩压和舒张压分别显著降低（-23 ± 3mmHg 和-10 ± 2mmHg）。虽然生化参数没有显著变化，但 BNP 血浆水平在此期间显著降低，尤其是在基线时 BNP 水平较高的患者中。
氯沙坦/HCTZ 治疗不仅显著降低了高血压患者的血压，还降低了 BNP 的血浆水平。这些发现表明，氯沙坦/HCTZ 可能对 BNP 水平较高的患者具有心脏保护作用。
