四种抗高血压药物对单纯收缩期高血压患者短期降压疗效的研究

摘要

目的 探讨双氢克尿噻、阿替洛尔、硝苯地平缓释片、卡托普利在中国乡镇农村社区未治疗单纯收缩期高血压中的短期降压疗效.方法 442例单纯收缩期高血压患者随机分配4组:双氢克尿噻组(给予双氢克尿噻 12.5 mg/d,qd)113例;阿替洛尔组(给予阿替洛尔 12.5 mg/d,bid)66例;硝苯地平组(给予硝苯地平缓释片 10 mg/d,bid)130例;卡托普利组(给予卡托普利 12.5 mg/d,bid)133例,比较4周后四种抗高血压药物的降压疗效.结果 4周后收缩压、舒张压在各组中均明显下降.阿替洛尔降低收缩压作用低于双氢克尿噻(P=0.033)和硝苯地平缓释片(P=0.005);双氢克尿噻降低舒张压作用明显低于硝苯地平缓释片(P=0.015);双氢克尿噻降低脉压作用明显大于阿替洛尔(P=0.006)和卡托普利(P=0.019);硝苯地平缓释片降低脉压作用明显高于阿替洛尔(P=0.026).双氢克尿噻1年的费用约为11元.结论 从降压疗效及经济学上,双氢克尿噻是适合中国农民单纯收缩期高血压的首选一线药物.从降低血压各组分上,双氢克尿噻及硝苯地平缓释片优于阿替洛尔和卡托普利.%Objective To investigate the short-term curative effect of hydrochlorothiazide ( HCTZ ), atenolol ( ATEN ), Nifedipine Sustained Rlease Tablets ( NSRT ) and captopril in patients with isolated systolic hypertension ( ISH ) without treatment from Chinese town and rural communities. Methods The patients with ISH were randomly divided into four groups including HCTZ group ( n = 113 with HCTZ, 12. 5 mg/d,once a day ),ATEN group ( n = 66 with ATEN, 12. 5 mg/s,twice a day ),NSRT group ( n = 130 with NSRT, 10 mg/d,twice a day ) and captopril group ( n = 133 with captopril, 12. 5 mg/d,twice a day ). The anti-hypertensive effect of these four kinds of medicinals was compared after 4 weeks. Results The systolic pressure and diastolic pressure decreased significantly in all groups after 4 weeks. The effect of reducing systolic pressure of ATEN was lower than that of HCTZ ( P =0. 033 ) and NSRT ( P = 0. 005 ). The effect of reducing diastolic pressure of HCTZ was significantly lower than that of NSRT (P = 0.015). The effect of reducing pulse pressure of HCTZ was significantly higher than that of ATEN ( P = 0. 006 ) and captopril ( P = 0.019 ). The effect of reducing pulse pressure of NSRT was significantly higher than that of ATEN ( P = 0. 026 ). The cost of HCTZ was about 11 RMB for one year. Conclusion From the aspect of anti-hypertension effect and economy, HCTZ is a first line medicinal being suitable to Chinese peasants with ISH, and from the aspect of reducing different components in blood pressure, HCTZ and NSRT are better than ATEN and captopril.