J Hypertens:高钠摄入的高血压人群降压治疗选择替米沙坦还是氢氯噻嗪?

2017-05-20 xing.T MedSci原创

由此可见,替米沙坦和氢氯噻嗪都是高钠摄入量的高血压患者有效地治疗药物。相比于氢氯噻嗪,替米沙坦具有更好的舒张压降低效果和较少的低血钾。需要进一步的研究以评估PP较大的患者氢氯噻嗪合理的优势效果。

近日,高血压领域权威杂志Journal of Hypertension上发表了一篇研究文章,研究人员旨在比较中国高钠摄入量的轻中度高血压患者采用40毫克/天的替米沙坦和25毫克/天的氢氯噻嗪的降血压效果。

在这项随机、双盲试验中,符合条件的患者被随机分为替米沙坦组和氢氯噻嗪组,并在招募入研究后15天、30天和60天随访3次,比较血压降低、低血钾和其他不良事件的情况。

研究人员从中国14个县医院共纳入了1333例轻中度高血压病患者,他们平均的钠摄入量为5909毫克/天。基线特征在各组间平衡良好。在15天、30天和60天的随访,替米沙坦和氢氯噻嗪组平均收缩压/舒张压分别减少了12.5/8、14.3/9.1、12.8/7.2和11/5.8、13.6/7.1、11.5/5.3mmHg。在三次随访中,替米沙坦具有比氢氯噻嗪较大的降血压效应,且具有统计学意义(P<0.001),无论有无调整基础血压、钠排泄量和脉压(PP)。收缩压下降与尿钠增加和两组的PP水平呈正相关,但是氢氯噻嗪组PP水平增加更快。相比于替米沙坦组(P=0.0238)。相比于替米沙坦,氢氯噻嗪治疗更容易出现低钾血症(0.4 vs. 4.5%,P<0.001)。

由此可见,替米沙坦和氢氯噻嗪都是高钠摄入量的高血压患者有效地治疗药物。相比于氢氯噻嗪,替米沙坦具有更好的舒张压降低效果和较少的低血钾。需要进一步的研究以评估PP较大的患者氢氯噻嗪合理的优势效果。

原始出处:

Zhang, Puhong,et al. Telmisartan and hydrochlorothiazide antihypertensive treatment in high sodium intake population: a randomized double-blind trial.Journal of Hypertension. 2017. http://journals.lww.com/jhypertension/Abstract/publishahead/Telmisartan_and_hydrochlorothiazide.97717.aspx

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    2017-06-20 fangcong
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    2017-11-13 feather89
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360863, encodeId=e598136086342, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon May 22 13:20:00 CST 2017, time=2017-05-22, status=1, ipAttribution=)]
    2017-06-18 1e1a6940m50(暂无匿称)

    学习了

    0

  6. 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  7. 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