Tedesco M A, Ratti G, Aquino D, Limongelli G, di Salvo G, Mennella S, Galzerano D, Iarussi D, Iacono A
Medical Surgical Institute of Cardiology, Second University of Naples, Italy.
J Hum Hypertens. 1998 Aug;12(8):505-10. doi: 10.1038/sj.jhh.1000685.
This study evaluated the anti-hypertensive efficacy, tolerability and effects on left ventricular mass of losartan, a selective angiotensin II receptor antagonist, after 22 months in patients with essential hypertension. The study included 77 hypertensive patients who were randomised at baseline to 22 months double-blind once-daily treatment with losartan 50 mg (L group n = 44 patients, mean age 54+/-9 years) or hydrochlorothiazide 25 mg (HCTZ group, n = 33 patients, mean age 56+/-7 years). Routine haematology, blood chemistry, standard electrocardiography, echocardiography and ambulatory non-invasive 24-h blood pressure (BP) monitoring were performed at baseline and after 10 and 22 months. The results showed good tolerability and a significant mean systolic and diastolic BP reduction in all groups (L group: 22 mm Hg and 11 mm Hg; HCTZ group: 11 mm Hg and 7 mm Hg, respectively for systolic and diastolic mean BP). Moreover, a remarkable reduction in left ventricular mass index was reached after 10 and 22 months only in the L group (L group: delta = -11 g/m2, P<0.02; HCTZ group: delta = -5 g/m2, P= 0.38). In conclusion, losartan was well tolerated and produced a significant reduction in BP and left ventricular mass in hypertensive patients
本研究评估了选择性血管紧张素II受体拮抗剂氯沙坦对原发性高血压患者22个月后的降压疗效、耐受性及对左心室质量的影响。该研究纳入了77例高血压患者，这些患者在基线时被随机分为两组，分别接受为期22个月的每日一次双盲治疗，其中一组服用50mg氯沙坦（L组，n = 44例患者，平均年龄54±9岁），另一组服用25mg氢氯噻嗪（HCTZ组，n = 33例患者，平均年龄56±7岁）。在基线时以及10个月和22个月后进行常规血液学检查、血液化学检查、标准心电图检查、超声心动图检查和动态无创24小时血压监测。结果显示，所有组的耐受性良好，收缩压和舒张压均显著降低（L组：收缩压降低22mmHg，舒张压降低11mmHg；HCTZ组：收缩压和舒张压平均分别降低11mmHg和7mmHg）。此外，仅在L组中，10个月和22个月后左心室质量指数显著降低（L组：Δ = -11g/m²，P<0.02；HCTZ组：Δ = -5g/m²，P = 0.38）。总之，氯沙坦耐受性良好，可使高血压患者的血压和左心室质量显著降低
