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目的通过系统比较15种降压药单药治疗原发性高血压的降压疗效,为医师选择有效降压药物时提供依据。方法对370例原发性高血压患者应用动态血压监测对15种单药治疗8周的降压疗效进行系统比较。结果氯沙坦、缬沙坦、厄贝沙坦、奥美沙坦、苯那普利、依那普利、美托洛尔、贝凡洛尔、吲达帕胺、贝尼地平和氨氯地平均有效降低24h平均舒张压和收缩压,坎地沙坦能有效降低收缩压。但各单药间降压幅度无差异。而低剂量特拉唑嗪、多沙唑嗪仅能降低日间舒张压,托拉塞米降低24h平均血压的效果不明显。结论血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂、β-阻滞剂和长效钙拮抗剂单药治疗能有效降压,而单用低剂量特拉唑嗪、多沙唑嗪和托拉塞米因短期作用有限,不建议作为单独药物治疗高血压,作为联合治疗可能更为适宜。
Objective To compare the antihypertensive effect of 15 kinds of antihypertensive drugs with those of essential hypertension in order to provide evidence for physicians to choose effective antihypertensive drugs. Methods 370 hypertensive patients with ambulatory blood pressure monitoring of 15 monotherapy for 8 weeks of systematic antihypertensive efficacy. Results Losartan, valsartan, irbesartan, olmesartan, benazepril, enalapril, metoprolol, bevantolol, indapamide, bezidipine and amlodipine Mean effective reduction of 24h mean diastolic blood pressure and systolic blood pressure, candesartan can effectively reduce systolic blood pressure. However, there is no difference between the single drug depressurization rate. The low-dose terazosin, doxazosin can only reduce the daytime diastolic blood pressure, torasemide reduce the average blood pressure 24h effect is not obvious. Conclusion Angiotensin converting enzyme inhibitors, angiotensin Ⅱ receptor antagonists, β-blockers and long-acting calcium antagonist monotherapy can be effective antihypertensive, and only low-dose terazosin, doxazosin Short-term effects of oxazine and torsemide are limited and it is not recommended as a separate drug for the treatment of hypertension, which may be more appropriate as a combination therapy.