新型固定剂量降压制剂安博诺理论与实践讲解.pptVIP

联合治疗减少或减轻不良反应的机制 通过不同的药理作用中和或对抗相互的不良反应 通过减少剂量避免不良反应。 在多种降压药物联合治疗方案中，ARB/HCTZ是一种双赢的联合方案。HCTZ明显提高ARB的降压幅度和速度;ARB显著减少和减轻HCTZ的不良反应。 Reduction in BP With Combination Therapy ARB抵销噻嗪类利尿剂的副作用 Thiazide Diuretics, Potassium, and the Development of Diabetes: A Quantitative Review 固定剂量联合制剂通过多层次设计(Factorial Design)和效应面分析(Response surface Analyses)研究，具有合理的剂量配伍。相对于处方临时联合，固定剂量联合简化治疗药品，减少治疗费用，提高长期治疗依从性和持续性，有利于血压控制达标。 Patient Adherence and Persistence with Antihypertensive Therapy:One- versus Two-pill Combination INCLUSIVE: Study Design INCLUSIVE Blood Pressure Goal Attainment at Week 2, 10, and 18 by Age Group BP Goal Achevement in Patients with Uncontrolled Hypertension Results of the Treat-to-Target Post-Marketing Survey with Irbesartan Treat-to-Target 结论 ● Irb/HCTZ能强效控制各种类型高血压， 包括代谢综合征。 ● Irb/HCTZ不良反应很低，仅0.62%。 ● Irb/HCTZ长期治疗依从性高达92%。 The principal finding of VALUE was that, for the primary composite endpoint of cardiac mortality and morbidity, there were no significant differences in these high-risk patients treated with valsartan- or amlodipine-based regimens.1 This was observed despite significant differences in achieved blood pressures. In a recent meta-regression analysis based on 30 hypertension trials with 149,407 patients, differences in achieved SBP were found to largely account for cardiovascular outcomes.2 1. Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high cardiovascular risk treated with valsartan- or amlodipine-based regimens: VALUE, a randomised trial. Lancet. 2004;363. 2. Staessen JA, Wang JG, Thijs L. Cardiovascular prevention and blood pressure reduction: a quantitative overview updated until 1 March 2003. J Hypertens. 2003;21:1055-1076. * Similar Low Rates of Laboratory Marker Abnormalities Observed in Both Treatment Groups1 The number of subjects with laboratory abnormalities meeting marked abnormality (MA) criteria during the double-blind period was low in both treatment groups. The most frequ