Effect of folic acid combined with hypotensive drug on type H hypertension
10.7683/xxyxyxb.2018.03.009
- VernacularTitle:叶酸联合降压药物治疗H型高血压效果分析
- Author:
Li-Chun FENG
1
Author Information
1. 三门峡市中心医院全科医学科
- Keywords:
type H hypertension;
folic acid;
homocysteine;
carotid atherosclerosis
- From:
Journal of Xinxiang Medical College
2018;35(3):196-200
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of folic acid and hypotensive drug on plasma homocysteine (Hcy),carotid atherosclerotic plaque and cerebral ischemic stroke in patients with type H hypertension.Methods A total of 300 patients with type H hypertension were randomly divided into control group and observation group,150 cases in each group.Eighty cases in the control group and twenty-six cases in the observation group were excluded during the follow-up period because of disobeying the doctor's advice or losing visits,132 cases in the control group and 124 cases in the observation group were rolled in this study at last.The patients in the control group were treated with conventional hypotensive drug.The patients in the observation group were treated with folic acid 2 mg orally,once a day for one year.The changes of blood pressure,plasma Hcy level,the carotid atherosclerosis and endpoint event were compared between the two groups.Results The systolic blood pressure(SBP) after 3 months of treatment was significantly lower than that after 6,9,and 12 months of treatment in the control group(P ＜ 0.05).The SBP after 12 months of treatment was significantly lower than that after 6 months of treatment in the control group(P ＜0.05).There was no statistic difference in the diastolic blood pressure(DBP) of patients at the time point of 3,6,9 months after treatment in the control group(P ＜0.05);the DBP of patients at the 12 months after treatment was significantly lower than that at the 3 months after treatment in the control group(P ＜0.05);there was no statistic difference in the DBP of patients at the 12 months after treatment and 6,9 months after treatment in the control group(P ＜ 0.05).The SBP after 6,9 and 12 months of treatment was significantly lower than that after 3 months of treatment in the observation group(P ＜0.05).The SBP after 9 and 12 months of treatment was significantly lower than that after 6 months of treatment in the observation group(P ＜0.05).The SBP after 12 months of treatment was significantly lower than that after 9 months of treatment in the observation group(P ＜ 0.05).The DBP after 6,9 and 12 months of treatment was significantly lower than that after 3 months of treatment in the observation group(P ＜0.05);but there was no significant difference in DBP between 6,9 and 12 months of treatment(P ＜0.05).The SBP and DBP in the observation group were significantly lower than those in the control group after 3,6,9 and 12 months of treatment(P ＜0.05).There was no significant difference in plasma Hcy level between the time points of 3,6,9 and 12 months of treatment(P ＜ 0.05).The plasma Hey level in the observation group decreased gradually after treatment,and there was significant difference between the different time points(P ＜ 0.05),and the plasma Hcy level in the observation group was significantly lower than that in the control group (P ＜ 0.05).There was no significant difference in carotid plaque detection rate and plaque stability between the two groups before treatment(x2 =0.303,0.422;P ＜ 0.05).Compared with before treatment,the carotid plaque detection rate decreased significantly (x2 =14.582,32.904;P ＜ 0.05),and the plaque stability increased significantly after 12 months of treatment in the two groups(x2 =35.352,12.878;P ＜ 0.05).Compared with the control group,the carotid plaque detection rate in the observation group decreased significantly(x2 =7.375,P ＜0.05),and the plaque stability increased significantly after 12 months of treatment(x2 =12.427,P ＜0.05).There was no significant difference in the intima-media thicknes(IMT),resistance index(RI) and plaque area between the two groups before treatment(P ＜0.05).The IMT,RI and plaque area after 12 months of treatment were significantly lower than those before treatment in the two groups(P ＜ 0.05);and the IMT,RI and plaque area in the observation group were significantly lower than those in the control group after 12 months of treatment (P ＜ 0.05).In the control group and the observation group,there were 17 cases(12.88) and 4 cases(3.23％) of stroke,7 cases(5.30％) and 4 cases(3.23％) of cardiovascular events,15 cases (11.36％) and 2 cases(1.61％) of death,respectively;the incidences of stroke and death in the observation group were significantly lower than those in the control group(x2 =7.912,9.805;P ＜0.05).There was no significant difference in the incidence of cardiovascular events between the two gmups(x2 =0.671,P ＜ 0.05).Conclusion Folic acid supplementation combined with antihypertensive treatment can significantly reduce the blood pressure and plasma Hey level,improve carotid atherosclerosis,and reduce the risks of stroke and death in patients with type H hypertension.
