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目的评价单用替米沙坦与替米沙坦联合吲达帕胺缓释片对老年原发性高血压患者的动态血压(ABP)、脉压(PP)、血压晨峰(MBPS)的影响。方法老年原发性高血压患者102例,随机分为替米沙坦组(80 mg/d,n=50)及替米沙坦联合吲达帕胺缓释片组(联合用药组,80 mg/1.5 mg,n=52),治疗前及治疗后12周监测24 h ABP,分别评估白天和夜间收缩压(SBP)、舒张压(DBP)、PP和凌晨5:00-8:00的血压及MBPS。结果治疗12周后,两组24 h的SBP、DBP和PP均较基线血压显著降低(均P<0.01),联合用药组24 h和白天SBP、DBP、PP的降幅均显著大于替米沙坦组(均P<0.05);联合用药组夜间SBP和PP的降低均显著大于替米沙坦组(均P<0.01),但DBP的降幅两组无显著差异(P>0.05);在服药间歇的最后4 h(凌晨5:00-8:00),两组SBP、DBP、PP均显著降低,联合用药组的降低程度显著大于替米沙坦组(P<0.01);联合用药组SBP和DBP的晨峰降幅亦显著大于替米沙坦组(P<0.01),MBPS减少百分比(31%)显著大于替米沙坦组的18%(P<0.01)。结论替米沙坦和替米沙坦联合吲达帕胺缓释片均可显著降低老年原发性高血压患者的动态SBP、DBP、PP、凌晨血压和MBPS,联合治疗显著优于单用替米沙坦,特别是血压晨峰。
Objective To evaluate the effect of telmisartan and telmisartan combined with extended-release tablets of indapamide on ambulatory blood pressure (ABP), pulse pressure (PP) and peak morning blood pressure (MBPS) in elderly patients with essential hypertension . Methods A total of 102 elderly patients with essential hypertension were randomly divided into telmisartan group (80 mg / d, n = 50) and telmisartan combined with indapamide sustained-release tablets group (combination group, 80 mg /1.5 mg, n = 52). ABP was monitored at 24 h before treatment and at 12 weeks after treatment. Day and night SBP, DBP, PP, and blood pressure of 5: 00-8: 00 in the morning And MBPS. Results After treatment for 12 weeks, SBP, DBP and PP in both groups decreased significantly (P <0.01) compared with those in baseline at 24 hours. The decrease of SBP, DBP, PP in 24 h and daytime in combination group was significantly greater than that in telmisartan (All P <0.05). The decrease of SBP and PP at night in combination group was significantly greater than that in telmisartan group (all P <0.01), but there was no significant difference in DBP decline between the two groups (P> 0.05) (5: 00-8: 00), the SBP, DBP and PP of the two groups were significantly lower than those of the telmisartan group (P <0.01). The SBP, The peak amplitude of DBP was also significantly lower than that of telmisartan group (P <0.01), and the percentage of MBPS reduction (31%) was significantly higher than that of telmisartan group (18%, P <0.01). Conclusion Telmisartan and telmisartan combined with sustained-release tablets of indapamide can significantly reduce the dynamic SBP, DBP, PP, early morning blood pressure and MBPS in elderly patients with essential hypertension, the combination therapy was significantly better than single use Misartan, especially blood pressure morning peak.