Takami Takeshi, Saito Yoshihiko
Department of Internal Medicine, Clinic Jingumae, Kashihara, Japan.
Vasc Health Risk Manag. 2011;7:383-90. doi: 10.2147/VHRM.S21991. Epub 2011 Jun 17.
The aim of this study was to compare the effects of olmesartan combined with either azelnidipine or amlodipine on central blood pressure (CBP) and left ventricular mass index (LVMI) in hypertensive patients.
Patients with brachial systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg received olmesartan monotherapy (20 mg daily) for 12 weeks. The patients were then randomly assigned to fixed-dose add-on therapy with azelnidipine (16 mg daily) or amlodipine (5 mg daily) (25 patients/group) for a further 24 weeks. CBP and LVMI were measured at baseline and at the end of the study.
Baseline characteristics were similar in both groups. The decrease in brachial BP was similar in both groups. CBP and LVMI decreased significantly in both groups (both, P < 0.001). However, the decreases in CBP and LVMI were significantly greater with olmesartan/azelnidipine than with olmesartan/amlodipine (CBP, P < 0.001; LVMI, P = 0.002).
These findings indicate that olmesartan/azelnidipine had greater effects on CBP and LVMI than did olmesartan/amlodipine, even though the reduction in brachial BP was similar in both groups. These differential effects on CBP and LVMI may have important implications for cardiovascular risk reduction.
本研究旨在比较奥美沙坦联合阿折地平或氨氯地平对高血压患者中心血压（CBP）和左心室质量指数（LVMI）的影响。
肱动脉收缩压≥140 mmHg和/或舒张压≥90 mmHg的患者接受奥美沙坦单药治疗（每日20 mg），持续12周。然后将患者随机分配至固定剂量的联合治疗组，分别给予阿折地平（每日16 mg）或氨氯地平（每日5 mg）（每组25例患者），持续治疗24周。在基线期和研究结束时测量CBP和LVMI。
两组的基线特征相似。两组肱动脉血压的下降幅度相似。两组的CBP和LVMI均显著下降（均P<0.001）。然而，奥美沙坦/阿折地平组CBP和LVMI的下降幅度显著大于奥美沙坦/氨氯地平组（CBP，P<0.001；LVMI，P = 0.002）。
这些结果表明，尽管两组肱动脉血压下降幅度相似，但奥美沙坦/阿折地平对CBP和LVMI的影响大于奥美沙坦/氨氯地平。这些对CBP和LVMI的不同影响可能对降低心血管风险具有重要意义。
