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目的左心室肥厚是高血压患者常见的并发症,应用降压药物逆转高血压左心室肥厚(left ventricular hypertrophy,LVH)效果不明确,本研究旨在评估及比较缬沙坦、苯磺酸氨氯地平治疗高血压效果及逆转高血压LVH的疗效。方法选择山东地区汉族老年人群轻、中度高血压伴左心室肥厚患者240例,各随机选取120例患者分别给予苯磺酸氨氯地平(5~10 mg/d),缬沙坦(80~160 mg/d)治疗。监测患者治疗前后的血压情况,治疗前后行心脏超声检查,测左室舒张末期内径(LVDd)、室间隔厚度(IVST)、左室后壁厚度(PWT)并计算左室重量指数(LVMI)的变化。结果研究人群治疗前的一般状况(年龄,BMI,高血压病程,SBP,DBP,LVMI)2组之间差异无统计学意义(P>0.05),应用配对样本的t检验计算治疗后所有高血压LVH患者LVMI、收缩压(SBP)、舒张压(DBP)均明显下降(t分别为24.156、32.469、22.680,P均<0.001),其中血压下降与药物类别无关,差异无统计学意义(P>0.05),应用多元线性回归计算,服用缬沙坦患者LVMI下降程度明显大于其他患者,差异具有统计学意义(F=6.713,P=0.012)。结论 2种药物均可以显著降低患者的血压及逆转LVH,其中降压效果差异无统计学意义,但应用缬沙坦逆转LVH效果更好。
Purpose Left ventricular hypertrophy is a common complication in hypertensive patients. The effect of antihypertensive drugs on reversing left ventricular hypertrophy (LVH) is not clear. This study was designed to evaluate and compare valsartan, Treatment of Hypertension with Topotecan and Reversal of the Effect of Hypertension LVH. Methods A total of 240 elderly patients with mild to moderate hypertension and left ventricular hypertrophy were enrolled in this study. 120 randomly selected patients were treated with amlodipine besylate (5-10 mg / d), valsartan (80 ~ 160 mg / d) treatment. The blood pressure before and after treatment, cardiac ultrasonography before and after treatment, left ventricular end diastolic diameter (LVDd), interventricular septum thickness (IVST) and left ventricular posterior wall thickness (PWT) were measured and left ventricular mass index Variety. Results There were no significant differences in general status (age, BMI, duration of hypertension, SBP, DBP, LVMI) between the two groups before treatment (P> 0.05). The paired sample t-test was used to calculate all the patients with hypertension LVMI, SBP and DBP in patients with LVH were significantly decreased (t = 24.156,32.469,22.680, P <0.001, respectively). No significant difference was found in the blood pressure between the two groups (P> 0.05). According to multivariate linear regression analysis, the decrease of LVMI in patients receiving valsartan was significantly greater than that in other patients (F = 6.713, P = 0.012). Conclusion Both drugs can significantly reduce the patients’ blood pressure and reverse the LVH, but the antihypertensive effects have no statistical significance. However, valsartan reversed the effect of LVH better.