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与奥美沙坦或氨氯地平单药治疗相比,奥美沙坦/氨氯地平单片复方治疗1年后高血压患者某些炎症标志物的变化。

Variation of some inflammatory markers in hypertensive patients after 1 year of olmesartan/amlodipine single-pill combination compared with olmesartan or amlodipine monotherapies.

作者信息

Derosa Giuseppe, Cicero Arrigo F G, Carbone Anna, Querci Fabrizio, Fogari Elena, D'Angelo Angela, Maffioli Pamela

机构信息

Department of Internal Medicine and Therapeutics, University of Pavia, Italy.

出版信息

J Am Soc Hypertens. 2013 Jan-Feb;7(1):32-9. doi: 10.1016/j.jash.2012.11.006.

Abstract

The purpose of this study was to evaluate a fixed olmesartan/amlodipine combination on blood pressure control, lipid profile, insulin sensitivity, and some inflammatory markers compared with single-drug monotherapy. A total of 276 hypertensive patients were randomly assigned to olmesartan 20 mg, amlodipine 10 mg, or a single pill containing olmesartan/amlodipine combination 20/5 mg for 12 months. We evaluated the following at baseline and after 6 and 12 months: body weight, body mass index, systolic (SBP) and diastolic blood pressures (DBP), fasting plasma glucose (FPG), fasting plasma insulin (FPI), lipid profile, tumor necrosis factor-α (TNF-α), retinol binding protein-4 (RBP-4), and interleukins 6 and 7 (IL-6 and IL-7). At baseline, and after 6 and 12 months, patients underwent an euglycemic, hyperinsulinemic clamp. The olmesartan/amlodipine combination provided a greater decrease of SBP and DPB compared with amlodipine and olmesartan monotherapies. The olmesartan/amlodipine combination decreased FPG after 12 months compared with amlodipine monotherapy. The combination decreased FPI and homeostasis model assessment index and increased M value both compared with baseline and with olmesartan and amlodipine monotherapies. Olmesartan/amlodipine decreased IL-7, but not IL-6, compared with single drug components. The olmesartan/amlodipine combination is effective and safe in reducing blood pressure and has some additive effects not shown by single drugs, such as an improvement of IL-7.

摘要

本研究的目的是评估固定剂量的奥美沙坦/氨氯地平复方制剂与单药治疗相比,在血压控制、血脂谱、胰岛素敏感性及一些炎症标志物方面的效果。总共276例高血压患者被随机分配至接受20毫克奥美沙坦、10毫克氨氯地平治疗,或服用含20/5毫克奥美沙坦/氨氯地平复方制剂的单片制剂,治疗12个月。我们在基线期、6个月及12个月后评估了以下指标:体重、体重指数、收缩压(SBP)和舒张压(DBP)、空腹血糖(FPG)、空腹血浆胰岛素(FPI)、血脂谱、肿瘤坏死因子-α(TNF-α)、视黄醇结合蛋白-4(RBP-4)以及白细胞介素6和7(IL-6和IL-7)。在基线期、6个月及12个月后,患者接受了正常血糖、高胰岛素钳夹试验。与氨氯地平和奥美沙坦单药治疗相比,奥美沙坦/氨氯地平复方制剂能使SBP和DBP有更大幅度的下降。与氨氯地平单药治疗相比,奥美沙坦/氨氯地平复方制剂在12个月后能降低FPG。与基线期以及奥美沙坦和氨氯地平单药治疗相比,该复方制剂降低了FPI和稳态模型评估指数,并提高了M值。与单药成分相比,奥美沙坦/氨氯地平降低了IL-7,但未降低IL-6。奥美沙坦/氨氯地平复方制剂在降低血压方面有效且安全,并且具有一些单药未显示的附加效应,如改善IL-7。

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