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替米沙坦联合氨氯地平治疗伴有附加风险的高血压患者的疗效和耐受性。

Efficacy and tolerability of telmisartan plus amlodipine in added-risk hypertensive patients.

机构信息

Department of Emergency Medicine, Ohio State University, Columbus, Ohio, USA.

出版信息

Curr Med Res Opin. 2011 Oct;27(10):1995-2008. doi: 10.1185/03007995.2011.616490. Epub 2011 Sep 12.

Abstract

OBJECTIVES

Added-risk hypertensive patients with co-morbidities such as diabetes and metabolic syndrome often require two or more antihypertensives to achieve blood pressure (BP) targets. The aim of this sub-analysis was to determine the efficacy and safety of telmisartan 40 or 80 mg plus amlodipine 5 or 10 mg in patients with hypertension, stratified according to certain criteria such as type 2 diabetes mellitus and metabolic syndrome.

METHODS

Patients were treated for 8 weeks with telmisartan 20-80 mg plus amlodipine 2.5-10 mg. This post-hoc analysis included patients treated with higher doses, and stratified according to a number of sub-populations (age, race, diabetes, obesity, metabolic syndrome, elevated baseline systolic BP (SBP), renal impairment).

RESULTS

Eight weeks' treatment with telmisartan plus amlodipine combinations provided consistent reductions in mean SBP/diastolic BP (DBP) across the different sub-populations, similar to the overall population. SBP/DBP reductions ranged from -13.5 to -34.7/-12.6 to -26.1 mmHg and BP goal rates (<140/90 mmHg) ranged from 29.8-100% for the four key dose combinations of telmisartan plus amlodipine. For the highest dose combination of telmisartan 80 mg plus amlodipine 10 mg, SBP/DBP reduction ranged from -19.1 to -34.7/-16.4 to -22.8 mmHg and goal attainment rate from 66.7% to 87.0%. Across the sub-populations, high SBP and DBP response rates were seen with combination treatment (83.3-97.7% and 75.0-95.7%, respectively, with telmisartan 80 mg plus amlodipine 10 mg). The combination was safe and well tolerated across all sub-populations and the incidence of peripheral oedema with telmisartan 40-80 mg plus amlodipine 10 mg was generally lower than with A10 monotherapy.

CONCLUSIONS

Despite small patient numbers in some sub-populations and the post-hoc nature of the analysis, this does show that the combination of telmisartan plus amlodipine provides an effective, safe and well-tolerated antihypertensive treatment for added-risk hypertensive patients.

摘要

目的

伴有糖尿病和代谢综合征等合并症的高危高血压患者通常需要两种或更多种降压药才能达到血压(BP)目标。本亚分析的目的是确定替米沙坦 40 或 80mg 加氨氯地平 5 或 10mg 在高血压患者中的疗效和安全性,这些患者根据某些标准(如 2 型糖尿病和代谢综合征)进行分层。

方法

患者接受替米沙坦 20-80mg 加氨氯地平 2.5-10mg 治疗 8 周。该事后分析包括接受高剂量治疗的患者,并根据多个亚人群(年龄、种族、糖尿病、肥胖、代谢综合征、基线收缩压(SBP)升高、肾功能损害)进行分层。

结果

替米沙坦加氨氯地平联合治疗 8 周可使不同亚人群的平均 SBP/舒张压(DBP)持续降低,与总体人群相似。SBP/DBP 降低范围为-13.5 至-34.7/-12.6 至-26.1mmHg,BP 目标达标率(<140/90mmHg)为替米沙坦加氨氯地平四种关键剂量组合的 29.8%至 100%。替米沙坦 80mg 加氨氯地平 10mg 的最高剂量组合,SBP/DBP 降低范围为-19.1 至-34.7/-16.4 至-22.8mmHg,达标率为 66.7%至 87.0%。在所有亚人群中,联合治疗的 SBP 和 DBP 反应率较高(分别为替米沙坦 80mg 加氨氯地平 10mg 为 83.3%至 97.7%和 75.0%至 95.7%)。联合治疗在所有亚人群中均安全且耐受良好,替米沙坦 40-80mg 加氨氯地平 10mg 的外周水肿发生率通常低于 A10 单药治疗。

结论

尽管某些亚人群的患者数量较少且分析为事后分析,但这确实表明替米沙坦加氨氯地平联合治疗为高危高血压患者提供了一种有效、安全且耐受良好的降压治疗方法。

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