摘要
目的观察老年高血压患者应用阿托伐他汀调脂联合贝那普利和氨氯地平降压的平稳性。方法 180例高血压患者(2～3级)随机分配到单纯降压组和调脂联合降压组,治疗前进行血脂及24h动态血压监测,所有高血压患者接受贝那普利和氨氯地平联合治疗2～4周,治疗后诊室血压达标后(<140/90mmHg)入组,调脂联合降压组加用阿托伐他汀(10mg,口服,1次/d),3月后2组分别进行血脂及24h动态血压监测;记录24h平均收缩压(24hSBP)及24h平均舒张压(24hDBP),计算24h收缩、舒张压平滑指数(SISBP和SIDBP)及脉压(PP)、脉压指数(PPI),分别比较2组病人治疗前后血脂、动态血压值及其稳定性的变化。结果 3月后,2组患者血压控制良好,与治疗前比较,调脂降压组患者:总胆固醇[(5.75±0.4)mmol/L比(3.77±0.15)mmol/L]、三酰甘油[(1.85±0.27)mmol/L比(1.23±0.10)mmol/L]水平明显降低(P<0.01);与单纯降压组相比,PP[(47±6)mmHg比(53±8)mmHg]及PPI[(0.36±0.08)mmHg比(0.40±0.06)mmHg]明显降低(P<0.05),而SISBP[(1.52±0.16)mmol/L比(1.40±0.15)mmol/L]和SIDBP[(1.37±0.13)mmol/L比(1.28±0.11)mmol/L]明显升高(P<0.05或P<0.01)。结论阿托伐他汀降脂联合降压治疗能更有效降低≥2级高血压患者动态血压的PP及PPI,并且明显提高血压平滑指数.
Objective To observe the effect of atorvastatin combined with benazepril and amlodipinethe in stability of blood pressure in elderly hypertensive patients. Methods 180 patients with grade 2 or 3 hypertension were randomly assigned to the simple depressurization group and combination group(lowering-lipid combined with depressurization). Blood lipids and 24 h ambulatory blood pressure were measured before treatment. All hypertensive patients received benazepril and amlodipine combination therapy until the blood pressure reached the standard, and the combination group received atorvastatin (10 mg,take orally,1time/d)additionaly. Blood lipids and 24 h ambulatory blood pressure were measured after 3 months. The smoothness index(SI) of 24 h systolic and diastolic blood pressure (SISBP and SIDBP), pulse pressure (PP)and pulse pressure index (PPI) were recorded. Blood lipids, ambulatory blood pressure values and their stability were respectively compared between the two groups of patients before and after treatment. Results After 3 months, blood pressure control in two groups is good.After 3 months,the levels of total cholesterol (5.75±0.4 mmol/L vs 3.77±0.15 mmol/L) and triglycerides (1.85±0.27 mmol/L vs 1.23±0.10 mmol/L) in combination group were decreased significantly than those before treatment(P<0.01); Compared with simple depressurization group, PP (47±6 mmHg vs 53±8 mmHg) and PPI (0.36±0.08 mmHg vs 0.40±0.06 mmHg)in combination group were significantly lower (P<0.05), while SISBP (1.52±0.16 mmol/L vs 1.40±0.15 mmol/L) and SIDBP (1.37±0.13 mmol/L vs 1.28±0.11 mmol/L) were significantly higher (P<0.05 or P< 0.01). Conclusions Atorvastatin combined antihypertensive therapy can more effectively reduce PP and PPI in patients with grade 2 or 3 hypertension, and significantly increase SI of blood pressure.
出处
《实用老年医学》
CAS
2013年第6期508-510,共3页
Practical Geriatrics
基金
上海市嘉定区卫生局青年基金课题(QWKYJJ)
关键词
阿托伐他汀
联合降压
平滑指数
老年人
atorvastatin
combining antihypertension
smoothness index
aged
