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缬沙坦治疗既往已治疗或未治疗的轻至中度高血压超重或肥胖患者的血压控制及体重减轻:一项比较治疗前和治疗后数值的开放标签研究

Blood pressure control and weight loss in overweight or obese patients with previously treated or untreated mild to moderate hypertension given valsartan: An open-label study comparing pretreatment and posttreatment values.

作者信息

Villecco Aldo S, Cocci Cinzia, Di Emidio Maurizio

机构信息

Department of Internal Medicine and Aging, Clinica Medica 11, Policlinico S. Orsola-Malpighi, Bologna, Italy.

出版信息

Curr Ther Res Clin Exp. 2004 Mar;65(2):172-84. doi: 10.1016/S0011-393X(04)90031-8.

Abstract

BACKGROUND

Hypertension is associated with obesity. Recent studies have indicated that therapy with an angiotensin II antagonist, in addition to having an antihypertensive effect, may cause a reduction in body weight.

OBJECTIVE

The aim of this study was to assess the efficacy and tolerability of valsartan in the treatment of overweight or obese patients with mild to moderate essential hypertension.

METHODS

Overweight or obese outpatients aged 18 to <70 years with previously treated or untreated mild to moderate essential hypertension were eligible for this open-label study conducted at the Department of Internal Medicine and Aging, Clinica Medica II, Policlinico S. Orsola-Malpighi (Bologna, Italy). After a 1-week pharmacologic washout period, patients were treated with valsartan capsules at a fixed dosage of 80 mg once daily for 8 weeks. The dosage was increased to 160 mg once daily if, at 8 weeks, diastolic blood pressure (DBP) was not normalized; otherwise, the 80-mg/d dosage was maintained. Treatment was continued for an additional 16 weeks. Patients' heart rate, systolic blood pressure (SBP) and DBP, body mass index (BMI), and waist-hip ratio (WHR) were measured/calculated at baseline (week 0) and 8, 16, and 24 weeks. Patients were asked to maintain a 1600-kcal/d diet throughout the study.

RESULTS

Forty-eight patients (28 men, 20 women; mean [SD] age, 57 [9] years) were included in the study. In the 45 patients (93.8%) who completed the study, mean SBP, DBP, and BMI were significantly decreased compared with baseline (all P < 0.001), but WHR was significantly increased (P < 0.05). After 24 weeks of treatment, 71.1 % of patients had SBP/DBP ≤ 140/≤90 mm Hg. Three patients (6.3%) withdrew from the study due to treatment-related adverse events.

CONCLUSION

In this population of overweight or obese patients with mild to moderate hypertension, valsartan was well tolerated, and could be effective in controlling blood pressure and achieving weight loss in such patients.

摘要

背景

高血压与肥胖相关。近期研究表明,血管紧张素II拮抗剂治疗除具有降压作用外,还可能使体重减轻。

目的

本研究旨在评估缬沙坦治疗超重或肥胖的轻至中度原发性高血压患者的疗效和耐受性。

方法

年龄在18至<70岁之间、有轻至中度原发性高血压病史且已接受治疗或未接受治疗的超重或肥胖门诊患者,符合在意大利博洛尼亚市圣奥索拉-马尔皮基综合医院临床医学II部内科与老年病科进行的这项开放标签研究的条件。经过1周的药物洗脱期后,患者接受缬沙坦胶囊治疗,固定剂量为每日1次,每次80mg,持续8周。如果在8周时舒张压(DBP)未恢复正常,则剂量增加至每日1次,每次160mg;否则,维持80mg/d的剂量。治疗持续16周。在基线(第0周)以及第8、16和24周测量/计算患者的心率、收缩压(SBP)和DBP、体重指数(BMI)以及腰臀比(WHR)。在整个研究过程中,要求患者维持1600千卡/天的饮食。

结果

48例患者(28例男性,20例女性;平均[标准差]年龄,57[9]岁)纳入研究。在完成研究的45例患者(93.8%)中,与基线相比,平均SBP、DBP和BMI显著降低(均P<0.001),但WHR显著升高(P<0.05)。治疗24周后,71.1%的患者SBP/DBP≤140/≤90mmHg。3例患者(6.3%)因治疗相关不良事件退出研究。

结论

在这群超重或肥胖的轻至中度高血压患者中,缬沙坦耐受性良好,可有效控制此类患者的血压并实现体重减轻。

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