Shiga Yuhei, Miura Shin-Ichiro, Motozato Kota, Yoshimine Yuka, Norimatsu Kenji, Arimura Tadaaki, Koyoshi Rie, Morii Joji, Kuwano Takashi, Inoue Ken, Shirotani Tetsuro, Fujisawa Kazuaki, Matsunaga Eiyu, Saku Keijiro
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan; Inoue Hospital, Fukuoka, Japan; Shirotani Hospital, Fukuoka, Japan.
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
J Clin Med Res. 2017 Feb;9(2):98-103. doi: 10.14740/jocmr2838w. Epub 2016 Dec 31.
Many patients continue to have high blood pressure (BP) even after treatment with high-dose (H)-angiotensin II type 1 receptor blocker (ARB)/calcium channel blocker (CCB) or middle-dose (M)-ARB/CCB/hydrochlorothiazide (HCTZ).
Thirty-two hypertensive patients who had the use of H-ARB/CCB or M-ARB/CCB/HCTZ were enrolled in this study. We applied a changeover with a switch to H-ARB (telmisartan 80 mg/day)/CCB (amlodipine 5 mg/day or nifedipine CR 40 mg/day)/HCTZ (12.5 mg/day).
Systolic BP (SBP) and diastolic BP (DBP) were significantly decreased in all patients and in the H-ARB/CCB and M-ARB/CCB/HCTZ groups after 3 months. Percentage (%) of patients who reached the target BP after 3 months (72%) in all patients was significantly higher than that at 0 months (19%). There were no serious adverse effects in any of the patients.
Combination therapy with H-ARB/CCB/HCTZ was associated with a significant reduction of BP.
许多患者即使在接受大剂量(H)-1型血管紧张素II受体阻滞剂(ARB)/钙通道阻滞剂(CCB)或中剂量(M)-ARB/CCB/氢氯噻嗪(HCTZ)治疗后仍患有高血压(BP)。
本研究纳入了32例使用H-ARB/CCB或M-ARB/CCB/HCTZ的高血压患者。我们采用了换药方案,改为使用H-ARB(替米沙坦80毫克/天)/CCB(氨氯地平5毫克/天或硝苯地平控释片40毫克/天)/HCTZ(12.5毫克/天)。
3个月后,所有患者以及H-ARB/CCB组和M-ARB/CCB/HCTZ组的收缩压(SBP)和舒张压(DBP)均显著降低。所有患者中3个月后达到目标血压的患者百分比(72%)显著高于0个月时(19%)。所有患者均未出现严重不良反应。
H-ARB/CCB/HCTZ联合治疗可显著降低血压。