| ObjectiveTo compare the efficacy of Valsartan and Bisoprolol alone or combined with other drugs in the treatment of mild to moderate hypertension in perimenopausal period and their short-term prognosis and improvement of adverse symptoms in perimenopausal period.MethodA total of 90 patients with mild to moderate hypertension in perimenopausal period were collected from November 2019 to November 2020 in the Central Hospital of Shenyang Medical College,they were randomly divided into three groups:Group A(Valsartan 80mg),group B(Bisoprolol 5mg)and group C(Valsartan 80 ng +Bisoprolol 5mg).All the patients were followed up for 30 days,24-hour ambulatory blood pressure monitoring(ABPM),24-hour ambulatory heart rate monitoring and modified Kupperman score were used to evaluate the improvement of perimenopausal adverse symptoms before,14 days after and 30 days after treatment respectively.The antihypertensive efficacy,short-term prognosis and improvement of perimenopausal adverse symptoms were compared among the three groups.24-hour all day average systolic blood press(ADASBP),24-hour all day average diastolic blood press(ADADBP),24-hour average heart rate(ADAHR),modified Kupperman score and incidence of events(Angina,myocardial infarction,heart failure,cardiogenic death,transient cerebral ischemia,cerebral hemorrhage,cerebral infarction)were recorded.The use rate of counting data(%)showed that the 2 test was used in the inter-group comparison,and the result of P <0.05 was statistically significant.Result1.follow-up results.(1)A group:30 cases were enrolled in the treatment group.After 30 days of follow-up,0 cases lost follow-up,1 case dropped out of the subject(1 case was treated with other antihypertensive drugs because of poor blood pressure control),and the remaining 29 cases.(2)B group:30 cases were enrolled in the treatment group.After 30 days of follow-up,0 cases lost follow-up,1 case dropped out of the subject(1 case stopped using drugs because of low heart rate and changed to other drugs),and the remaining29 cases.(3)C group:30 cases were enrolled in the treatment group.after 30 days of followup,0 cases lost follow-up,0 cases dropped out of the subject,and the remaining 30 cases.2.Comparison of baseline characteristics among three groups of patients.There was no significant difference in clinical baseline characteristics such as age,ADASBP,ADADBP,ADAHR and modified Kupperman score among the treatment groups.3.Comparison of blood pressure before and after treatment in three groups(1)Comparison of blood pressure before and after treatment in Group AFor ADASBP and ADADBP,the blood pressure decreased significantly after 14 and 30 days and before treatment.ADASBP(147.28 ± 6.72 mm Hg vs 138.48 ± 6.27 mm Hg,P < 0.01),(147.28 ± 6.72 mm Hg vs 137.10 ± 5.78 mm Hg,P < 0.01),ADADBP(73.90 ± 7.44 mm Hg vs 70.10 ± 6.52 mm Hg,P<0.05),ADADBP(73.90 ±7.44 mm Hg vs 70.10 ± 6.52 mm Hg,P<0.05),(73.90 ± 7.44 mm Hg vs 69.34 ± 6.08 mm Hg,P < 0.01),for ADASBP and ADADBP after 14 and 30 days,ADASBP (138.48 ± 6.27 mm Hg vs 137.10 ± 5.78 mm Hg)and ADADBP(70.10 ± 6.52 vs 69.34± 6.08 mm Hg)had no significant change(P>0.05).(2)The results of group B and group C were the same as group A.4.Three groups of patients were compared between the treatment of14 days,30 days of antihypertensive effect(1)Comparison of antihypertensive effect between group A and group B for 14 days and 30 daysThere was no significant difference in ADASBP between group A and group B before treatment(147.28 ± 6.72 mm Hg vs 148.55 ± 7.60 mm Hg,P>0.05),and there was no significant difference in ADASBP between group A and group B after 14 and30 days of treatment(138.48 ± 6.27 mm Hg vs 136.34 ± 7.10 mm Hg,P > 0.05),(137.10 ± 5.78 mm Hg vs 134.45 ± 6.03 mm Hg,P>0.05),no significant difference in ADADBP between the two groups before treatment(73.90 ± 7.44 mm Hg vs 75.76 ±5.93 mm Hg,P>0.05),There was no significant difference in ADADBP between the two groups after 14 and 30 days of treatment(70.10 ± 6.52 mm Hg vs 69.76 ± 4.33 mm Hg,P>0.05),(69.34 ± 6.08 mm Hg vs 69.07 ± 3.88 mm Hg,P>0.05).(2)Comparison of antihypertensive effect between group A and group C for 14 days and 30 daysThere was no significant difference in ADASBP beween group A and group C before treatment(147.28 ± 6.72 mm Hg vs 146.93 ± 6.93 mm Hg,P>0.05).ADASBP in Group C was significantly lower than that in group a after 14 and 30 days of treatment(138.48 ± 6.27 mm Hg vs 128.17 ± 6.21 mm Hg,P<0.01),(137.10 ± 5.78 mm Hg vs 127.07 ± 5.79 mm Hg,P<0.01);Before treatment,there was no significant difference in ADADBP between the two groups(73.90±7.44 mm Hg vs 76.70±7.38 mm Hg,P>0.05).After 14 days and 30 days,the ADADBP was(70.10±6.52 mm Hg vs 66.93 ±4.24 mm Hg,P < 0.05),(69.34±6.08 mm Hg vs 66.17±3.82 mm Hg,P <0.05).(3)Comparison of antihypertensive effect between group B and group C for 14 days and 30 days,the group C are all below the group A.There was no significant difference in ADASBP between group B and group C(148.55 ± 7.60 mm Hg vs 146.93 ± 6.93 mm Hg,P>0.05).ADASBP in group C was significantly lower than that in group B(128.17 ± 6.21 mm Hg vs136.34 ±7.10 mm Hg,P<0.01),(127.07 ± 5.79 mm Hg vs134.45 ± 6.03 mm Hg,P<0.01);There was no significant difference in ADADBP between the two groups before treatment(75.76 ±5.93 mm Hg vs 76.70 ± 7.38 mm Hg,P>0.05).After 14 days of treatment and 30 days of treatment,ADADBP in group C was significantly lower than that in Group B(69.76±4.33 mm Hg vs 66.93±4.24 mm Hg,P < 0.05),(69.07±3.88 mm Hg vs66.17±3.82 mm Hg,P<0.01).5.Comparison of modified Kupperman score in three groupsThere was no significant difference in Kupperman score between the three groups before Treatment(P>0.05);The Kupperman score of group A was significantly lower than that of group after 30 days of treatment(1.07±2.03分对15.02±1.67分,P<0.05);After 14 days of treatment,the score in group B was significantly lower(17.48±2.34 vs 15.09±1.62,P<0.01),After 30 days of treatment,there was a further decrease(17.48±2.3vs 13.48±1.74,P<0.01);group C had the same results as group B.The improved Kupperman score in group C was significantly lower than that in group(14.97±1.92 vs 16.73±1.64,P<0.05),After 30 days of treatment,the difference between the two groups was Greater(11.87±1.85 vs 15.02± 1.67,P<0.01);After 30 days treatment,the modified Kupperman score in group C was significantly lower than that in group B(11.87±1.85 vs 13.48±1.74,P<0.05).5.Comparison of total MACE events among three groups of patientsThe total incidence of Mace in group A,Group B and group C was 34.5%,10.3%and 6.7% respectively within 30 days of treatment,The total incidence of Mace in group B and group C was similar(P>0.05),which was lower than that in group A(P<0.05).Conclusion1.The systolic and diastolic blood pressure of patients with mild to moderate hypertension in perimenopausal period decreased significantly after 14 or 30 days of treatment compared with that before treatment,with the greatest decrease after the combined treatment of Valsartan,bisoprolol and the two drugs,Valsarta and Bisoprolol had similar effects on blood pressure,but there was no significant change in blood pressure after 30 days compared with 14 days.2.Although the effect of Bisoprolol and Valsartan on blood pressure in patients with mild to moderate hypertension in perimenopausal period is similar,the early application of Bisoprolol(14 days)can significantly improve the symptoms and prognosis of perimenopausal period,it took 30 days for Valsartan to improve perimenopausal symptoms.Therefore,the effect of Bisoprolol is better for mild to moderate hypertension patients in perimenopausal period.If blood pressure control is not good,bisoprolol combination therapy should be preferred. |
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