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J Hypertens:替米沙坦比氢氯噻嗪降舒张压更优

2017-05-22 卢芳 中国循环杂志

对于饮食喜咸,多药联合依从性又不好的轻中度高血压患者,采用单药治疗效果如何?近期,北京大学医学部乔治健康研究所和北京大学人民医院学者发表于J Hypertens上的一项研究表明,对于这部分患者,每天40 mg的替米沙坦或25 mg的氢氯噻嗪都有效,而前者降压效果明显更好,尤其是舒张压。研究显示,在接受替米沙坦或氢氯噻嗪的两组轻中度高血压患者,治疗后15天、30天和60天时,替米沙坦组平均收缩压/舒

对于饮食喜咸,多药联合依从性又不好的轻中度高血压患者,采用单药治疗效果如何?

近期,北京大学医学部乔治健康研究所和北京大学人民医院学者发表于J Hypertens上的一项研究表明,对于这部分患者,每天40 mg的替米沙坦或25 mg的氢氯噻嗪都有效,而前者降压效果明显更好,尤其是舒张压。

研究显示,在接受替米沙坦或氢氯噻嗪的两组轻中度高血压患者,治疗后15天、30天和60天时,替米沙坦组平均收缩压/舒张压分别降低了12.5/8 mmHg、14.3/9.1 mmHg、12.8/7.2 mmHg;氢氯噻嗪组平均降低了11/5.8 mmHg、13.6/7.1 mmHg、11.5/5.3 mmHg。

在校正基础血压、钠排泄量和脉压后,替米沙坦的降压效果犹胜一筹。

研究显示,两组中收缩压下降与尿钠增加和脉压水平正相关,但氢氯噻嗪组对脉压变化更为敏感。研究者认为,对于脉压较大的患者,还需进一步去评估氢氯噻嗪治疗的合理优势。

这项随机、双盲试验共纳入中国14个县医院1333例轻中度高血压患者,受试者每日平均钠摄入量为5909 mg。

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    2018-04-07 fangcong
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time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201644, encodeId=ad7a2016449c, content=非常好的文章,学习了,很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue May 23 11:51:47 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-06-23 周周人

    学习。

    0

  5. 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time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201644, encodeId=ad7a2016449c, content=非常好的文章,学习了,很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue May 23 11:51:47 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-06-06 laoli

    谢谢分享,学习了!

    0

  6. 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time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201644, encodeId=ad7a2016449c, content=非常好的文章,学习了,很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue May 23 11:51:47 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-24 大爰

    好文章学习并分享!

    0

  7. 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    2017-05-23 天涯183

    非常好的文章,学习了,很受益

    0

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在高血压患者中,为期4年的脑室周围WMH进展与认知能力下降有关,而基线脑室周围WMH和认知能力的下降之间无相关性。这些结果强调了预防高血压患者WMH进展的重要性。

J Hypertens:老年高血压患者的体力活动与认知功能有啥关系?

由此可见,在全国高血压老年人样本中,符合体力活动指南的参与者与较高的认知功能有关。

AIM:年轻人心血管疾病风险升高情况如何?大数据横断面研究告诉你

背景:美国心脏病学会和美国心脏学会(ACC/AHA) 的2013胆固醇管理指南推荐在所有20岁以上的成人中进行血脂筛查来识别动脉粥样硬化性心血管疾病(ASCVD)风险的增加。他汀类药物可被用于10年风险较高者(>5%) 或低密度脂蛋白胆固醇(LDL-C)水平≥4.92 mmol/L (190 mg/dL) 的患者。目的:本研究的目的是描述在小于50岁的非糖尿病成人中,心血管疾病风险升高的发生

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?

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。

Circulation:强化降低血压对高血压患者左心室肥厚的影响!

目前尚不清楚超出推荐值的强化血压(BP)降低是否会导致高血压患者的左心室肥大(LVH)风险降低;也尚不清楚,LVH的风险降低是否可以解释在这个人群中所报告的对心血管疾病( CVD)的益处。近期,一项发表在杂志Circulation上的研究分析了8,164名具有高血压但无糖尿病的参与者(平均年龄67.9岁,女性35.3%,31.2%黑人)的收缩期血压干预(SPRINT)试验;4,086名参与者随机分

J Hypertens:叶酸治疗降低大量蛋白尿的高血压患者死亡风险!

由此可见,在没有主要心血管疾病史的高血压患者中,叶酸治疗可以降低重度蛋白尿患者相关的死亡风险。

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