Fressinaud P, Berrut G, Gallois H
Centre Hospitalier Universitaire, Angers.
Ann Cardiol Angeiol (Paris). 1993 Jan;42(1):51-9.
Efficacy and acceptability of perindopril (Coversyl) in general practice were evaluated in 23,460 hypertensive patients (52.9% women) during an open six month trial. Patients had essential mild to moderate hypertension (94 mmHg < supine DBP < 115 mmHg) associated or not with obesity (34%), diabetes (12%), hypercholesterolemia (36%), smoking habits (24%). Mean hypertension duration was 6.5 years, 70 p. cent of patients were 50 to 69 years old and 12 p. cent 70 years old or more. Perindopril was started at 4 mg except in older and patients with renal insufficiency (2 mg). If supine DBP remained > 90 mmHg the dose was doubled up to 8 mg/day, then a thiazide diuretic was added. Monotherapy was held in 90 p. cent of cases all along the study, more than 8 over 10 times at 2 or 4 mg/day. Normalized patients (DBP < or = 90 mmHg) were 69.87 and 95 p. cent respectively at the first, third and sixth month. Mean supine SBP and DBP decrease were 27.3 and 18.0 mmHg. Antihypertensive activity was similar in patients taking psychotrope or non steroidal anti-inflammatory agents and in others, as well as in older (> or = 70 years), diabetics and obeses, however with a significantly more frequent bitherapy in these last three sub-groups. Cough, a well known side effect of ACEI led to withdrawal in only 2.6 p. cent of cases. Withdrawals for side-effect were more frequent in older patients (6.1%), in those taking psychotrope (5.3%) or non steroidal anti-inflammatory agents (6.0%) than in diabetics (4.1%) or the others (4.1%).(ABSTRACT TRUNCATED AT 250 WORDS)
在一项为期6个月的开放性试验中,对23460例高血压患者(52.9%为女性)评估了培哚普利(雅施达)在全科医疗中的疗效和可接受性。患者患有原发性轻至中度高血压(仰卧位舒张压94 mmHg<DBP<115 mmHg),伴有或不伴有肥胖(34%)、糖尿病(12%)、高胆固醇血症(36%)、吸烟习惯(24%)。高血压平均病程为6.5年,70%的患者年龄在50至69岁之间,12%的患者年龄在70岁及以上。除老年患者和肾功能不全患者起始剂量为2 mg外,培哚普利起始剂量为4 mg。如果仰卧位DBP仍>90 mmHg,则剂量加倍至8 mg/天,然后加用噻嗪类利尿剂。在整个研究过程中,90%的病例采用单药治疗,超过十分之八的时间采用2或4 mg/天的剂量。在第1、3和6个月时,血压正常(DBP≤90 mmHg)的患者分别为69.87%和95%。仰卧位收缩压和舒张压平均下降分别为27.3 mmHg和18.0 mmHg。服用精神药物或非甾体抗炎药的患者与其他患者的降压活性相似,老年患者(≥70岁)、糖尿病患者和肥胖患者也是如此,然而在这最后三个亚组中联合治疗更为常见。咳嗽是ACEI众所周知的副作用,仅导致2.6%的病例停药。老年患者(6.1%)、服用精神药物的患者(5.3%)或非甾体抗炎药的患者(6.0%)因副作用停药的频率高于糖尿病患者(4.1%)或其他患者(4.1%)。(摘要截选至250字)