Kumolosasi Endang, Ng Wen Bin, Abdul Aziz Siti Azdiah
Universiti Kebangsaan Malaysia, Faculty of Pharmacy, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Wilayah Persekutuan 50300, Malaysia.
Med J Malaysia. 2012 Aug;67(4):379-85.
Hypertension has been identified as one of the causes for end stage renal failure (ESRF) and is likely to worsen kidney function. This retrospective study was carried out at a tertiary hospital in Malaysia with the objective of determining the effectiveness of combination antihypertensive drugs in hypertensive patients with ESRF admitted between 2006 and 2008. Patients with incomplete data and who were on monotherapy were excluded from this study. Although six different combinations gave significant reductions in systolic blood pressure (SBP) (13.38 +/- 9.11 mmHg, p < 0.05) and diastolic blood pressure (DBP) (6.03 +/- 11.39 mmHg, p < 0.05), 69.16% patients did not achieve target blood pressure (BP) (< or = 130/80 mmHg). Combination of beta blocker (BB) with calcium channel blocker (CCB) was the most commonly used. The CCB-diuretic regimen achieved highest percentage of BP control compared to others (40%). Comparison of blood pressure reduction between different combinations of antihypertensive drugs were not significant (p > 0.05) except for CCB-diuretics and BB-CCB-alpha blocker. The findings suggested better BP control with CCB-diuretic relative to other combinations used.
高血压已被确认为终末期肾衰竭(ESRF)的病因之一,且可能会使肾功能恶化。这项回顾性研究在马来西亚一家三级医院开展,目的是确定联合使用抗高血压药物对2006年至2008年期间收治的ESRF高血压患者的疗效。数据不完整以及接受单一疗法的患者被排除在本研究之外。尽管六种不同的联合用药方案使收缩压(SBP)显著降低(13.38±9.11 mmHg,p<0.05),舒张压(DBP)也显著降低(6.03±11.39 mmHg,p<0.05),但69.16%的患者未达到目标血压(<或=130/80 mmHg)。β受体阻滞剂(BB)与钙通道阻滞剂(CCB)联合使用最为常见。与其他方案相比,CCB-利尿剂方案实现血压控制的百分比最高(40%)。除CCB-利尿剂和BB-CCB-α受体阻滞剂外,不同抗高血压药物联合使用在降低血压方面的比较无显著差异(p>0.05)。研究结果表明,与其他联合用药方案相比,CCB-利尿剂能更好地控制血压。