Effect Of Valsartan And Amlodipine On Elderly Patients With Hypertension

To observe the effects of valsartan amlodipine compound preparation combined with valsartan and amlodipine besylate on antihypertensive efficacy,cardiac structure,prognosis,medication compliance and drug cost in elderly patients with hypertension.MethodA total of 120 elderly patients with hypertension admitted to the Affiliated Central Hospital of Shenyang Medical College from October 2020 to October2021 were randomly divided into group A（valsartan amlodipine tablet 80mg/5mg）and group B（valsartan 80mg+ amlodipine besylate 5mg）.Both groups were treated for 24 weeks.The incidence of ADASBP,ADADBP,LVEDD,LAD,IVS,LVPW,MACE,medication compliance and drug cost in 2 groups were observed before treatment and 6,12,24 weeks after treatment.Result1.Follow upIn group A,60 patients were enrolled.After 24 weeks of follow-up,2 patients were detached and the remaining 58 patients were observed.Group B included 60 cases,followed up for 24 weeks,18 cases shed,the remaining 42 cases completed observation.2.Comparison of baseline characteristics between the two groupsBefore treatment,there were no significant differences in gender,age,ADASBP,ADADBP,LVEDD,LAD,IVS,LVPW,compliance and other clinical baseline characteristics between 2 groups（P>0.05）.3.Changes of blood pressure in the two groups before and after treatment（1）The ADASBP of the two groups before treatment,6 weeks,12 weeks and24 weeks were as follows: group A（169.91 ± 6.81 mm Hg,151.57 ± 3.08 mm Hg,136.41±3.01 mm Hg,131.64±3.10 mm Hg）;Group B（168.43±7.74 mm Hg,151.95±3.84 mm Hg,136.74±3.52 mm Hg,131.74±3.69 mm Hg）.In both groups,compared with before treatment,ADASBP significantly decreased at 6 weeks after treatment（P<0.01）,and further decreased at 12 weeks after treatment（P<0.01）.After that,ADASBP decreased slowly to 24 weeks after treatment,but still decreased somewhat（P < 0.01）.There was no statistical difference in the decrease of ADASBP between group A and B at 6,12 or 24 weeks of treatment（P>0.05）.（2）The ADADBP of the two groups before treatment,6 weeks,12 weeks and24 weeks were as follows: group A（100.10 ± 5.92 mmhg,90.34 ± 6.08 mmhg,84.31±5.82 mmhg,80.69±5.83mmhg）;Group B（98.74±5.74 mm Hg,90.50±5.81 mm Hg,84.67±5.21 mm Hg,80.17±7.00 mm Hg）.In both groups,compared with before treatment,ADADBP decreased significantly at 6 weeks after treatment（P < 0.01）,and further decreased at 12 weeks after treatment（P < 0.01）.After that,ADADBP decreased slowly to 24 weeks after treatment,but still decreased somewhat（P < 0.01）.There was no significant difference in the decrease of ADADBP between group A and B at 6,12 or 24 weeks of treatment（P>0.05）.4.Improvement of cardiac structure of the two groups before and after treatment（1）Comparison of LVEDD between the two groups: LVEDD in group A was significantly lower than that before treatment（52.21 ± 2.94 mm vs 53.91 ±3.97mm;P<0.01）,and LVEDD in group B was significantly lower than that before treatment（52.02±3.48 mm vs 53.57±4.71mm;P<0.01）.Both group A and group B could reduce LVEDD,and there was no difference in the reduction degree of LVEDD between the two treatment schemes P>0.05).（2）Comparison of LAD between the two groups: lad in group A was significantly lower than that before treatment（37.53 ± 3.57 mm vs.39.07 ±4.21mm;P<0.01）,and LAD in group B was significantly lower than that before treatment（37.33±3.16 mm vs.38.83±3.81mm;P<0.01）.Both group A and group B could reduce lad,and there was no difference in the degree of LAD reduction between the two treatment schemes（P>0.05）.（3）Comparison of LVPW between the two groups: LVPW in group A was significantly lower than that before treatment（12.19 ± 1.62 mm vs.13.02 ±1.95mm;P<0.01）,and LVPW in group B was significantly lower than that before treatment（12.05±1.77 mm vs.12.86±2.10mm;P<0.01）.Both group A and group B could significantly reduce LVPW,and there was no difference in the reduction degree of LVPW between the two treatment schemes（P>0.05）.（4）Comparison of IVS between the two groups: IVS in group A was significantly lower than that before treatment（12.28 ± 1.74 mm vs.13.07 ±2.01mm;P<0.01）,and IVS in group B was significantly lower than that before treatment（12.36 ± 1.69 mm vs.13.14 ± 1.97mm;P < 0.01）.Both group A and group B could significantly reduce the IVS,and there was no difference in the reduction degree of IVS between the two treatment schemes（P>0.05）.5.Incidence of mace events in the two groupsThere was no significant difference in the incidence of mace events between the two groups after 24 weeks of treatment（5.17% vs 7.14%,P>0.05）.6.Medication compliance of patients in the two groupsThe medication compliance of group A was significantly better than group B after 24 weeks of treatment,and the difference was statistically significant（P<0.01）.7.Drug costs of patients in the two groupsThe two groups were treated for 24 weeks respectively.Compared with group B,the average cost of drugs in group A was 367.2 yuan per person,A decrease of24.87%.Conclusion1.Valsartan amlodipine single-pill combination and free combination of valsartan and amlodipine besylate can improve the blood pressure of elderly patients with hypertension,and the antihypertensive effect of the two treatment plans is similar.2.Valsartan amlodipine single-pill combination and free combination of valsartan and amlodipine besylate can improve left atrial diameter,left ventricular end diastolic diameter,ventricular septal thickness,and left ventricular posterior wall thickness,suggesting that both treatments can reverse cardiac remodeling,and the effects of the two treatments are comparable.3.In terms of prognosis,valsartan amlodipine single-pill combination and free combination of valsartan and amlodipine besylate had similar prognosis.4.In terms of compliance,the compliance of elderly patients with hypertension with valsartan amlodipine single-pill combination was significantly better than that of valsartan and amlodipine besylate combined treatment.5.In terms of drug cost,valsartan and amlodipine besylate single tablet compound preparation cost less than valsartan and amlodipine besylate free combination treatment,and has more advantages.