Ma Yongxian, Li Wei, Liu Yunfeng, Li Li
Department of Cardiovascular Medicine, Baoji High-Tech Hospital No. 19 Gaoxin Fourth Road, Weibin District, Baoji 721000, Shaanxi, China.
Department of Cardiovascular Medicine, Xiangyang Central Hospital No. 136 Jingzhou Street, Xiangcheng District, Xiangyang 441000, Hubei, China.
Am J Transl Res. 2024 Jul 15;16(7):3036-3045. doi: 10.62347/LXJB8350. eCollection 2024.
To evaluate the efficacy of empagliflozin combined with sacubitril/valsartan in treating hypertensive patients with heart failure (HF), focusing on its effects on blood pressure variability (BPV) and cardiac function.
This retrospective study included 101 patients with hypertension and heart failure with reduced ejection fraction treated at Baoji High-Tech Hospital from October 2021 to October 2023. Patients were divided into two groups: an observation group (n=51), treated with both empagliflozin and sacubitril/valsartan, and a control group (n=50), treated with sacubitril/valsartan alone. We compared the therapeutic effects, BPV (including 24-hour, daytime, and nighttime systolic and diastolic BPV), cardiac function indicators, levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) before and after treatment, and the incidence of adverse reactions between the groups. Independent risk factors affecting treatment efficacy were also analyzed.
The total effective rate of treatment in the observation group was significantly higher than in the control group (P<0.05). Both groups showed reductions in daytime and nighttime systolic and diastolic BPV after treatment, with the observation group displaying more pronounced improvements (all P<0.05). Enhancements in cardiac ultrasound measurements, NT-proBNP levels, and cTnI levels were more significant in the observation group compared to the control group post-treatment (both P<0.05). There was no significant difference in the incidence of adverse reactions during treatment between the two groups (P>0.05). Age and comorbid diabetes were identified as independent risk factors for poor prognosis, while treatment with empagliflozin combined with sacubitril/valsartan was a protective factor.
Empagliflozin combined with sacubitril/valsartan significantly enhances treatment efficacy in hypertensive patients with heart failure, effectively improves cardiac function and BPV, and demonstrates good safety.
评估恩格列净联合沙库巴曲缬沙坦治疗高血压合并心力衰竭（HF）患者的疗效，重点关注其对血压变异性（BPV）和心脏功能的影响。
本回顾性研究纳入了2021年10月至2023年10月在宝鸡高新医院接受治疗的101例射血分数降低的高血压合并心力衰竭患者。患者分为两组：观察组（n = 51），接受恩格列净和沙库巴曲缬沙坦联合治疗；对照组（n = 50），仅接受沙库巴曲缬沙坦治疗。比较两组治疗效果、BPV（包括24小时、白天和夜间收缩压和舒张压BPV）、心脏功能指标、治疗前后N末端脑钠肽前体（NT-proBNP）和心肌肌钙蛋白I（cTnI）水平以及不良反应发生率。还分析了影响治疗效果的独立危险因素。
观察组治疗总有效率显著高于对照组（P<0.05）。两组治疗后白天和夜间收缩压和舒张压BPV均降低，观察组改善更明显（均P<0.05）。治疗后，观察组心脏超声测量、NT-proBNP水平和cTnI水平的改善比对照组更显著（均P<0.05）。两组治疗期间不良反应发生率无显著差异（P>0.05）。年龄和合并糖尿病被确定为预后不良的独立危险因素，而恩格列净联合沙库巴曲缬沙坦治疗是一个保护因素。
恩格列净联合沙库巴曲缬沙坦显著提高高血压合并心力衰竭患者的治疗效果，有效改善心脏功能和BPV，并显示出良好的安全性。
