缬沙坦/氨氯地平复方制剂与硝苯地平控释片单药治疗对高血压患者肱动脉脉压和桡动脉增强指数的影响。

Effects of the valsartan/amlodipine combination and nifedipine gastrointestinal therapeutic system monotherapy on brachial pulse pressure and radial augmentation index in hypertensive patients.

机构信息

Shanghai Key Laboratory of Hypertension, Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai.

Department of Geriatrics, People's Hospital of Hangzhou Medical College, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.

出版信息

Blood Press Monit. 2021 Aug 1;26(4):251-256. doi: 10.1097/MBP.0000000000000527.

DOI:10.1097/MBP.0000000000000527

PMID:33734121

Abstract

OBJECTIVE

In a substudy of a randomized controlled trial, we investigated the effects of the valsartan/amlodipine single-pill combination and nifedipine gastrointestinal therapeutic system (GITS) monotherapy on brachial pulse pressure (bPP) and radial augmentation index (rAI) in patients with previously uncontrolled hypertension.

METHODS

We performed measurements of clinic blood pressure (BP) and pulse rate and rAI (n = 63) and ambulatory BP monitoring (n = 42) at baseline and 12-week of follow-up. Analysis of covariance was performed to calculate the least square mean change from baseline and between-group differences [95% confidence interval (CI)]. Correlation analysis was performed to study the interrelationship between the changes in bPP and rAI and in pulse rate.

RESULTS

After 12-week treatment, clinic and ambulatory SBP/DBP and pulse rate were not differently changed between the valsartan/amlodipine (n = 29) and nifedipine GITS groups (n = 34, P ≥ 0.06) except daytime SBP (P = 0.01). The reductions in 24-h and daytime ambulatory bPP were significantly greater in the former than the latter group (P ≤ 0.04). rAI increased slightly by 3.5% (P = 0.20) and 5.2% (P = 0.06) in the valsartan/amlodipine and nifedipine groups, respectively, with a between-group difference of -1.7% (95% CI -9.6 to 6.1%, P = 0.66). In the two groups combined, the changes in clinic and ambulatory bPP were not or weakly associated with that in clinic or ambulatory pulse rate (r = -0.14 to 0.36, P = 0.02-0.95), while the changes in rAI were more strongly or significantly associated with that in clinic or ambulatory pulse rate (r = -0.39 to -0.23, P = 0.02-0.16).

CONCLUSIONS

Antihypertensive drug-induced changes in rAI but not bPP were dependent on pulse rate.

摘要

目的

在一项随机对照试验的子研究中，我们研究了缬沙坦/氨氯地平单片复方制剂与硝苯地平控释片单药治疗对先前血压控制不佳的患者肱动脉脉搏压（bPP）和桡动脉增强指数（rAI）的影响。

方法

我们在基线和随访 12 周时进行了诊室血压（BP）和脉搏率以及 rAI（n=63）的测量和动态血压监测（n=42）。采用协方差分析计算自基线的最小二乘均数变化和组间差异[95%置信区间（CI）]。进行相关性分析以研究 bPP 和 rAI 以及脉搏率变化之间的相互关系。

结果

在 12 周的治疗后，诊室和动态收缩压/舒张压和脉搏率在缬沙坦/氨氯地平组（n=29）和硝苯地平控释片组（n=34，P≥0.06）之间没有差异，除了白天收缩压（P=0.01）。前者较后者组 24 小时和白天动态 bPP 的降低更显著（P≤0.04）。rAI 分别增加了 3.5%（P=0.20）和 5.2%（P=0.06），组间差异为-1.7%（95%CI -9.6 至 6.1%，P=0.66）。在两组联合治疗中，诊室和动态 bPP 的变化与诊室或动态脉搏率的变化无关或弱相关（r=-0.14 至 0.36，P=0.02-0.95），而 rAI 的变化与诊室或动态脉搏率的变化更密切或显著相关（r=-0.39 至-0.23，P=0.02-0.16）。