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氯沙坦/氢氯噻嗪固定剂量复方制剂治疗未控制高血压患者的降压疗效：一项多中心研究。

Antihypertensive effect of a fixed-dose combination of losartan/hydrochlorothiazide in patients with uncontrolled hypertension: a multicenter study.

机构信息

Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan.

出版信息

Clin Exp Nephrol. 2012 Apr;16(2):269-78. doi: 10.1007/s10157-011-0564-4. Epub 2011 Nov 30.

DOI:10.1007/s10157-011-0564-4
PMID:22127399
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3328675/
Abstract

BACKGROUND

Achieving adequate blood pressure (BP) control often requires more than one antihypertensive agent. The purpose of this study was to determine whether a fixed-dose formulation of losartan (LOS) plus hydrochlorothiazide (HCTZ) (LOS/HCTZ) is effective in achieving a greater BP lowering in patients with uncontrolled hypertension.

METHODS

The study was a prospective, multicenter, observational trial exploring the antihypertensive effect of a single tablet of LOS 50 mg/HCTZ 12.5 mg. A total of 228 patients whose BP had previously been treated with more than one antihypertensive agents without having achieved BP goal below 130/80 mmHg enrolled in the study.

RESULTS

A significant decrease in systolic and diastolic BP was observed in both clinic and home measurement after switching from the previous treatment to LOS/HCTZ. There was a significant decrease in both B-type natriuretic peptide (BNP) and urinary albumin creatinine (Cr) excretion ratio (ACR), especially in patients with elevated values. In contrast, there was a significant increase in serum Cr concentration in conjunction with a decrease in estimated glomerular filtration rate (eGFR). Overall serum uric acid (UA) concentration increased, whereas in patients with hyperuricemia there was a significant reduction in this value.

CONCLUSION

Switching to LOS/HCTZ provides a greater reduction in clinic and home BP in patients with uncontrolled hypertension. This combination therapy may lead to cardio-, reno protection and improve UA metabolism.

摘要

背景

实现足够的血压（BP）控制通常需要一种以上的降压药物。本研究的目的是确定洛沙坦（LOS）加氢氯噻嗪（HCTZ）的固定剂量配方（LOS/HCTZ）是否能有效降低未控制高血压患者的血压。

方法

该研究是一项前瞻性、多中心、观察性试验，探讨了洛沙坦 50mg/HCTZ 12.5mg 单片治疗的降压效果。共有 228 名患者在本研究中接受了治疗，他们之前使用了一种以上的降压药物，但血压仍未达到 130/80mmHg 以下的目标。

结果

从之前的治疗方案转换为 LOS/HCTZ 后，诊室和家庭测量的收缩压和舒张压均显著下降。B 型利钠肽（BNP）和尿白蛋白肌酐（Cr）排泄率（ACR）均显著下降，尤其是在升高的患者中。相反，血清 Cr 浓度显著升高，同时估计肾小球滤过率（eGFR）下降。总体血清尿酸（UA）浓度升高，而在高尿酸血症患者中，该值显著降低。

结论

转换为 LOS/HCTZ 可使未控制高血压患者的诊室和家庭血压降低更明显。这种联合治疗可能会导致心脏、肾脏保护，并改善 UA 代谢。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/3328675/5d73aacf7831/10157_2011_564_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/3328675/5375d90cc959/10157_2011_564_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/3328675/5fe93c435cc7/10157_2011_564_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/3328675/e0c3abce03ea/10157_2011_564_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/3328675/5d73aacf7831/10157_2011_564_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/3328675/5375d90cc959/10157_2011_564_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/3328675/5fe93c435cc7/10157_2011_564_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/3328675/e0c3abce03ea/10157_2011_564_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/3328675/5d73aacf7831/10157_2011_564_Fig7_HTML.jpg

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