Yin Gang, Li Yuefan, Xu Wenjie, Han Na
Medicine (Baltimore). 2019 Dec;98(51):e18471. doi: 10.1097/MD.0000000000018471.
This study aimed to compare the Hamilton anxiety rating/Hamilton depression rating (HAMA/HAMD) scale scores and blood pressure (BP) goal achievement associated with the use of valsartan-amlodipine single-pill combinations (SPCs) versus valsartan and amlodipine combination in adult hypertensive patients.A total of 476 hypertensive patients were randomly assigned into the SPC (valsartan-amlodipine) and control (valsartan and amlodipine combination) groups. All patients had an uncontrolled BP (160-179/100-109 mm Hg). BP goal was <140/90 mm Hg. Cox proportional hazards regression analysis was used to analyze the likelihood of HAMA/HAMD scales, SPCs, control group, and daily dosage number. Kaplan-Meier analysis was used to estimate the rates of BP goal achievement over time among the 2 groups.A total of 476 patients were included in the study, and 439 patients completed the follow-up and received the index drug therapy. There was a significant difference in BP between the 2 groups on days 28, 42, and 56. Patients who received SPCs had a significantly higher rate of BP goal achievement over time (P = .000). The average HAMD scores in the SPC and control groups were 5.54 and 5.49 and 6.06 and 6.21 on days 28 and 56, respectively. The average HAMA scores in the SPC and control groups were 7.41 and 7.13 and 7.90 and 8.01 on days 28 and 56, respectively. The means of HAMD and HAMA scores were 5.826 and 7.614, respectively. The higher the HAMA/HAMD scores, the lower was the BP goal achievement. The number of drugs taken by the patients was associated with the HAMA and HAMD scores. There was no significant difference between HAMA scores of patients taking 1 tablet daily (7.22 ± 1.885) and those taking two-tablets daily (7.38 ± 1.953) (P = .408). However, when these scores were compared to those of patients taking 4 tablets daily (8.08 ± 2.285), a significant difference was observed (P = .000, P = .000).Hypertensive patients treated with valsartan-amlodipine SPCs were significantly more likely to achieve BP goal and have lesser HAMA/HAMD scores compared to patients treated with valsartan and amlodipine combination.
本研究旨在比较缬沙坦 - 氨氯地平单片复方制剂(SPC)与缬沙坦和氨氯地平联合用药在成年高血压患者中使用时,汉密尔顿焦虑量表/汉密尔顿抑郁量表(HAMA/HAMD)评分及血压(BP)目标达成情况。总共476例高血压患者被随机分为SPC组(缬沙坦 - 氨氯地平)和对照组(缬沙坦与氨氯地平联合用药组)。所有患者血压均未得到控制(160 - 179/100 - 109 mmHg)。血压目标为<140/90 mmHg。采用Cox比例风险回归分析来分析HAMA/HAMD量表、SPC组、对照组及每日用药剂量数的可能性。采用Kaplan - Meier分析来估计两组随时间推移的血压目标达成率。本研究共纳入476例患者,439例患者完成随访并接受了指数药物治疗。在第28、42和56天时,两组血压存在显著差异。接受SPC治疗的患者随时间推移血压目标达成率显著更高(P = .000)。SPC组和对照组在第28天和第56天的平均HAMD评分分别为5.54和5.49以及为6.06和6.21。SPC组和对照组在第28天和第56天的平均HAMA评分分别为7.41和7.13以及7.90和8.01。HAMD和HAMA评分的均值分别为5.826和7.614。HAMA/HAMD评分越高,血压目标达成率越低。患者服用的药物数量与HAMA和HAMD评分相关。每日服用1片(7.22 ± 1.885)的患者与每日服用2片(7.38 ± 1.953)的患者的HAMA评分无显著差异(P = .408)。然而,将这些评分与每日服用4片(8.08 ± 2.285)的患者评分相比,观察到显著差异(P = .000,P = .000)。与接受缬沙坦和氨氯地平联合治疗的患者相比,接受缬沙坦 - 氨氯地平SPC治疗的高血压患者更有可能实现血压目标且HAMA/HAMD评分更低。