Effects of valsartan with or without benazepril on blood pressure, angiotensin Ⅱ, and endoxin in patients with essential hypertension  

缬沙坦单用或与苯那普利联合应用对原发性高血压患者血压和血管紧张素Ⅱ及内洋地黄素水平的影响(英文)

作　　者：柯永胜 陶月玉[1] 杨浩[2] 俞国华[2] 

机构地区：[1]第二军医大学南京海军414医院心脏科 [2]皖南医学院弋矶山医院心脏科,芜湖241001

出　　处：《Acta Pharmacologica Sinica》2003年第4期51-55,98,共6页中国药理学报（英文版）

摘　　要：AIM: To evaluate the effects of valsartan (Val) with or without benazepril (Ben) on blood pressure and plasma levels of angiotensin (Ang Ⅱ) and digoxin-immunoreactive factors (endoxin) in patients with essential hypertension. METHODS: Ninety patients with essential hypertension were randomly divided into 3 groups (n=30 per group): Ben group (Ben 10 mg/d, po); Val group (Val 80 mg/d, po); combination drug therapy group (Val 80 mg/d+Ben 10 mg/d, po); all patients were treated for 12 weeks. Age and sex-matched 20 normal subjects were served as control group. RESULTS: The levels of plasma endoxin and Ang Ⅱ in patients with essential hypertension were remarkably higher than those in normal subjects. The levels of plasma Ang Ⅱ and endoxin were all obvious positive correlation with systolic blood pressure (SBP) and diastolic blood pressure (DBP) (Ang Ⅱ: r=0.5151, 0.7978; endoxin: r=0.4706, 0.7274, respectively). Within 6 weeks of drug intervene, SBP and DBP were remarkably decreased in 3 groups. After 6 weeks, SBP and DBP were continuously decreased in Ben group and Val+Ben group, but not in Val group. Level of plasma Ang Ⅱ was remarkably decreased as SBP and DBP decreased in Ben group and Val+Ben group; level of plasma Ang Ⅱ was remarkably increased in Val group. CONCLUSION: Val with or without Ben remarkably decreased SBP and DBP in patients with essential hypertension within 6 weeks. Antihypertensive efficacy was weakened after long-term use of Val alone. The antihypertensive effect of Val+Ben group was the most remarkable among 3 groups and could avoid the side effects of high plasma Ang Ⅱ.目的:评价缬沙坦单用或与苯那普利联合应用对原发性高血压患者血压和血管紧张素Ⅱ(Ang Ⅱ)及内洋地黄素水平的影响。方法:90例原发性高血压患者随机分成3组,每组30例。苯那普利组:每日口服苯那普利10 mg;缬沙坦组:每日口服缬沙坦80 mg;联合药物组:每日口服苯那普利10 mg和缬沙坦80 mg,持续12周。年龄和性别匹配的20例健康人作为正常对照组。结果:原发性高血压患者血浆内洋地黄素和Ang Ⅱ水平显著高于正常人。血浆内洋地黄素和Ang Ⅱ水平均与收缩压和舒张压水平呈显著正相关。在药物干预的6周内,3组患者的收缩压和舒张压均显著降低:6周后,苯那普利组和联合药物治疗组血压继续降低,但缬沙坦组血压不再继续降低。随着血压降低,苯那普利组和联合药物治疗组血浆Ang Ⅱ水平显著降低,而缬沙坦组血浆Ang Ⅱ水平显著升高。结论:缬沙坦单用或与苯那普利联合应用在6周内均能显著降低原发性高血压患者血压,但长时间单用缬沙坦则抗高血压作用减弱。在3组中,联合药物治疗组的抗高血压作用最佳,且能避免单用缬沙坦所致血浆Ang Ⅱ水平的升高。内洋地黄素可能参与原发性高血压的发病机制。因此,长期单用AT_1受体拮抗剂缬沙坦治疗原发性高血压可能是不恰当的。

关 键 词：hypertension VALSARTAN BENAZEPRIL combination drug therapy DIGOXIN immunologic factors angiotensin Ⅱ 

分 类 号：R544.1[医药卫生—心血管疾病]