Effects of valsartan combined with amlodipine or hydrochlorothiazide regimen on blood pressure variation in elderly hypertensive patients
10.3760/cma.j.issn.0253-3758.2012.01.003
- VernacularTitle:缬沙坦联合氨氯地平或氢氯噻嗪对老年高血压患者血压变异性的影响
- Author:
Ze-Bing WU
1
;
Ying ZHANG
;
Qi-Gui YU
;
Cai-Xia SUN
;
Wu Cun TAO
Author Information
1. 安徽医科大学第三附属医院合肥市第一人民医院
- Keywords:
Hypertension;
Variation of blood pressure;
Drug therapy,combination
- From:
Chinese Journal of Cardiology
2012;40(1):8-13
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effects of valsartan combined with amlodipine or hydrochlorothiazide regimen on blood pressure variation and plasma nitric oxide(NO)and endothelin(ET)in elderly hypertensive patients.Methods A total of 61 elderly patients with grade 2 or 3 hypertension were randomized into valsartan + amlodipine(the amlodipine group,n =31)or valsartan + hydrochlorothiazide (the hvdrochlorothiazide group,n =30)group.Blood lipids,fasting plasma glucose and uric acid were determined before the treatment.24-hour dynamic blood pressure,NO and ET were monitored at baseline,8 and 16 weeks after treatment.Results 24 hours blood pressure and daytime blood pressure were similarbetween two groups at all 3 time points.At 16 weeks,morning systolic blood pressure surge was significantly lower in amlodipine group than in hydrochlorothiazide group[(22.6 ±8.8)mm Hg(1 mm Hg =0.133 kPa)vs.(26.3 ± 13.7)mm Hg,P ＜ 0.05].24 hours systolic blood pressure variability(SBPV)decreased progressively in both groups[the amlodipine group:(12.5 ±2.8)mm Hg vs.(10.2 ±2.2)mm Hg vs.(8.8 ±1.6)mm Hg,P ＜0.01;the hydrochlorothiazide group:(12.5 ±2.5)mm Hg vs.(10.7 ±2.2)mm Hg vs.(9.6 ±2.0)mm Hg,P ＜ 0.01].Daytime SBPV also decreased progressively in both groups[the amlodipinegroup:(12.2±3.0)mm Hgvs.(10.1 ±2.3)mm Hgvs.(8.4±1.9)mm Hg,P＜0.01;the hydrochlorothiazide group:(11.8 ± 2.7)mm Hg vs.(10.4 ± 1.9)mm Hg vs.(9.6 ± 2.2)mm Hg,P ＜0.01].24 hours diastolic blood pressure variability(DBPV)was significantly reduced post therapy in the amlodipine group[(15.5 ±3.4)mm Hgvs.(13.0±3.5)mm Hgvs.(12.3±2.5),P＜0.01]but not in the hydrochlorothiazide group.NO increased progressively[(27.3 ± 13.6)μmol/L vs.(47.2 ± 16.3)μmol/L vs.(69.5 ± 18.9)μmol/L in the anlodipine group,P ＜ 0.0l ;(33.5 ± 13.9)μmol/L vs.(49.7 ±21.9)μmol/L vs.(66.7 ± 24.7)μmol/L in the hydrochlorothiazide group,P ＜ 0.01]and ET decreased progressively[(45.3 ±8.0)ng/L vs.(37.4 ±3.9)ng/L vs.(34.2 ±4.4)ng/l in the arnlodipine group,P ＜0.01 ;(46.6 ± 10.4)ng/L vs.(37.0 ± 5.4)ng/L vs.(36.1 ± 8.2)ng/L in the hydrochlorothiazide group,P ＜ 0.01]in both groups.Conclusion Valsartan in combination with amlodipine or hydroehlorothiazide can both effectively lower BPV in elderly hypertensive patients and improve the vascular endothelial function and the former regimen is more suitable for elderly hypertensive patients.
