左旋氨氯地平和贝那普利对老年单纯收缩期高血压患者动态血压的影响.docVIP

　　左旋氨氯地平和贝那普利对老年单纯收缩期高血压患者动态血压的影响 【关键词】 左旋氨氯地平 贝那普利 老年单纯收缩期高血压 动态血压 ［Abstract］ObjectiveTo evaluate the efficacy of levomlodipin and benazepril on 24 h dynamic blood pressure(ABPM) in elderly patients ild to moderate isolated systolic hypertension(ISH).MethodsSixty elderly patients ly divided into tg/d levomlodipine,10 mg/d benazepril respectively for 4 ent.Results(1)After 4 ent,there m Hg(Plt;0.001) and(4.83 ±4.82)mm Hg in the levomlodipine group,by(14.30 ±7.26)mm Hg(Plt; 0.001) and(4.97 ±2.87)mm Hg in the benazepril group.24 h mean blood pressure(MAP) decreased by(8.86 ±4.76)mm Hg(Plt; 0.001) in levomlodipine group,decreased(8.74±3.07)mm Hg(Plt;0.001) in benazepril group.(2) PP decreased by(16.97±14.06)mm Hg ( Plt;0.001) in the levomlodipine group,by(8.33 ±7.84)mm Hg(P lt;0.001) in the benazepril group.(3) Both drugs ilarly effective in 76.7 % patients and 73.3 %patients respectively (P=0.766),and goal blood pressure lodipin,56.7 % lodipine group,16.67 % in the benazepril group.Conclusion(1) The data sholodipin and benazepril can significantly decrease SBP,MAP and PP.There are no significant differences in lolodipin 5 mg,and benazepril 10 mg once daily is effective and safe in patients ild to moderate hypertension. ［Key lodipine;benazepril;pharmacologic action;isolated systolic hypertension;elderly;dynamic blood pressure 老年人最常见的高血压是单纯收缩期高血压（isolated systolic hypertension,ISH)，约占老年高血压的79.01%。60岁以上的老年群体中ISH所致的心脑血管并发症和死亡日益受到重视,已肯定是冠心病、脑卒中的独立危险因素之一,其发病率为11.7%［1］。多组研究资料证明，收缩压升高的危险性高于舒张压升高。而心脑血管事件的降低首要是心脏病防治研究工作。国内对高血压综合 治疗 的报道较少,为了提高ISH的控制率,找出更有效的治疗方法,本研究应用24 h动态血压监测(ambulatory blood pressure monitor,ABPM)方法,探讨并比较不同类型的缓释降压药对老年ISH的影响,为合理选择降压药物提供依据。 1对象与方法 1.1对象与分组1998年1月～2000年12月来我院高血压科门诊及住院的老年纯收缩期高血压患者60例,男女各30例,年龄60～70岁,平均（64.1±3.3）岁。病历采集标准:根据1999年。采用美国SPACELABS公司的SPACE型无创式动态血压监测仪,ABPM袖带固定于左上肢,24 h血压测定为8∶00～24∶00和0∶00～8∶00两阶段,前者为白昼血压,每20 min测1次,后者为夜间血压,每30 min测1次。分项判定用药前后24 h平均收缩压(24 h mean systolic blood pressure,24 h SBP),24 h平均舒张压(24 h mean diastolic blood