| Hypertension has been a major illness that threatens people’s life and health.Researches suggest that Atherosclerosis (AS) caused by hypertension can lead to somesevere illnesses such as myocardial infarction and cerebrovascular disease.Hypertension and dyslipidemia can also result in the damage of endothelial function aswell as the decrease of arterial elasticity. It is indicated in a great many researches thatcardiovascular events are closely related to the decrease of arterial elasticity and theincrease of arterial stiffness. Currently, a lot of evidence-based medicine researchesmainly focus on the patients with dyslipidemia, thus failing to pay attention to those ofnormal lipidemia but with one or two cardiovascular risk factors. Additionally, based onthe use of the hypotensor, applying statins, especially Amlodipine/Atorvastatin helpsreduce incidence and mortality rate of cardiovascular disease among the hypertensives.However, few researches have been carried out to observe the early changes ofatherosclerosis caused by Amlodipine/Atorvastatin, in which endothelial function andarterial elasticity of the hypertensives are the two main indexes. Because of the obviousrelationship between morning blood pressure and the incidence of cardiovasculardisease, keeping morning blood pressure under control can reduce the incidence ofcardiovascular disease. Objective: To invest whether the application of Amlodipine/Atorvastatincombined with hypotensor can make a difference to the patients’ ambulatory bloodpressure, vascular endothelial function and blood vessel elasticity, compared with theeach application of hypotensor. The conclusion can be drawn by closely observing thehypertensives without hyperlipidmia but with one or two cardiovascular risk factors.Method: The162participants in this survey are chosen from the outpatients orinpatients from Sep.2011to June.2012. and took the following three medicinesrespectively: domestic Compound Hypotensive tablets, Amlodipine Tablets andAmlodipine/Atorvastatin. They were aged either below75or above30withoutlimitation of gender and had normal lipidemia but with one or two cardiovascular riskfactors. After3-month follow-up study,144participants remained, among whom44were named Group One (taking domestic Compound Hypotensive tablets);48namedGroup Two (taking Amlodipine Tablets) and52named Group Three (taking Amlodipine/Atorvastatin). The diagnosis for all the participants is based on the hypertensionguideline in WHO/ISH in1999, i.e. Systolic blood pressure(SBP)≥140mmHg or/andDiastolic blood pressure(DBP)≥90mmHg, which is in correspondence with the criteriaof Chinese Hypertension Guideline2010. The lipidemia of the selected participantsmust be: Total Cholesterol (TC)≤200mg/dl, Low-density lipoprotein Cholesterol(LDL-C)≤120mg/dl， Triglycerides (TG)≤150mg/dl, corresponding to the lipidemiamanagement guideline of ESC/ESH2011. The research was carried out with the writtenpermission of all the selected participants. Inquired about the history, the participantswere given, before and after the3-month follow-up, a blood biochemical examination,hs-CRP,24hABPM with the Space medical instrument90207-18Q made in Britain,Flow Mediated-Dilation (FMD) and endothelium-independent dilatation (EID) with theHP Sonos5500Ultrasonic Color Doppler system made by American HP,and Carotid-femoral pulse wave velocity withVS-1000arteriosclerosis testing system made byBeijing FuTian Electric. All data have beem processed and analyzed by SPSS20.0andEXCEL2007. Using one way ANOVA to compare between these three groups andx±Sto demonstrate the result.If P <0.05, there is statistical difference. Results:1. the basic files for the three groups have no statistical differences(p>0.05) which include age, gender, body mass index, smoking history, triglyceride,low-density lipoprotein cholesterol, total cholesterol, high-density lipoprotein, hs-CRP.2. after taking3different hypotensor pills for3months,24h ABPM of all the groups hasbeen lower than before. The differential has statistical significance. Moreover, group2and group3had no difference and did a better job in24h ABPM compare with Group1.3. After the treatment, group1had no change in morning blood pressure, while group2and3had an obvious control over morning blood pressure.4. The FMD of all thegroups has been improved, and the differential has statistical significance. The group3did the best, flowed by group2and group1. But there is no difference in EID.5. Afterthe treatment, the pulse wave velocity of group2and3has been bettered with astatistical significance. Group1has no change. There is no statistical significanceamong the three groups.6. After taking the pills, the lipidemia for the participants ingroup3has declined while group1and2had no change. And hs-CRP of group2and3has also declined, and the differential has statistical significance. But group1had nochange. Besides, there is statistical significance in group2and3compared with group1while no statistical significance between group2and3themselves.Conclusions:1.24h ABPM of the three groups were reduced after takingmedicines3months,among which Amlodipine and Amlodipine/Atorvastatin is betterthan domestic compound hypotensor. In addition, morning blood pressure can beeffectively controlled by Amlodipine and Amlodipine/Atorvastatin.2.Vessecularendothelium was improved by Amlodipine and Amlodipine/Atorvastatin after3months.3.After3months arterial elasticity was inproved by Amlodipine andAmlodipine/Atorvastatin... |
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