动态血压监测15种单药治疗原发性高血压的降压疗效  

Efficacy of Monotherapy with 15 Antihypertensive Agents in Treating Essential Hypertension Assessed by 24-hour Ambulatory Blood Pressure Monitoring

作　　者：华丛笑[1] 华潞[1] 李娜[1] 王莉[1] 庞会敏[1] 明广华[1] 黄岩[1] 成小如[1] 刘红[1] 吴瑛[1] 许莉[1] 康健[1] 顼志敏[1] 李一石[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院卫生部心血管药物临床研究重点实验室,北京100037

出　　处：《中国医学科学院学报》2007年第6期792-796,共5页Acta Academiae Medicinae Sinicae

摘　　要：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 evaluate the efficacy of the monotherapy of 15 agents in treating essential hypertension. Methods After 2-week wash-out, a total of 370 patients with seated diastolic blood pressure 95- 114 mmHg and seated systolic blood pressure 〈 180 mmHg were randomized to different therapeutic groups. 24-hour ambulatory blood pressure monitoring was performed before medication and at the end of 8 weeks. Result All the agents significantly reduced the 24 hour mean blood pressures after treatment except doxazosin, terazosin, and torasemide. Conclusion The result suggested that the angiotensin-converting enzyme inhibitots, angiotensin Ⅱ receptor blockers, β-blockers and long-acting calcium antagonists were effective in treating essential hypertension, while the low-dose doxazosin, terazosin and torasemide can be used for combination therapy but not for monotherapy.

关 键 词：原发性高血压 单药治疗 动态血压监测 

分 类 号：R544.1[医药卫生—心血管疾病]