| Hypertension is one of the most common cardiovascular diseases. And it is a serious health problem in the world. There are 90 million patients with hypertension in our country, with incidence increasing continuously, while without ideal awareness rate, treatment rate and controlling rate. Large amount of animal experiments and clinical trials have demonstrated that angiotensin-converting enzyme inhibitor (ACEI) contributes a lot in the treatment of hypertension. It has explicit effect on hypertension and excellent protection of target organ. It is recommended for the first time by JNC7 as the first-line medication for simple hypertension and stage 1 hypertension. And it is the only one that has all the 6 compelling indications. It acts by inhibiting circulating and histologic RAAS. Thus it inhibits transformation of AngI to AngII and leads to lowering of blood pressure by decreasing production of AngII. At the same time, it protects Kallikrein-Kinin system and increases bradykinin. So it can lead to dilation of blood vessel and production of vascular dilating factor such as prostaglandin I2, nitric oxygen, endothelium-derived hyperpolarizing factor. As a member of ACEI, enalapril has been used in clinical work for many years. Lots of trials and experiments have demonstrated its excellent effect and protection of target organ. Dihydrochlorothiazide (DHCT) lowers blood pressure by decreasing cardiac output. The first-line position of DHCT in the treatment of hypertension has also been settled. The compound medication by the two mentioned drugs acts by different mechanisms. Thus it is a good prescription because two drugs work in coordination which increase effectiveness and decrease adverse events. Some trials have been performed in other countries to compare the effectiveness of compound prescription with different dosage. But the patients were from Europe and American.Dosage and conclusions were different among those trials. There are no such studies in our country at present. In order to verify the effectiveness and safety of compound agent and to find a suitable dose for clinical work, 126 patients with mild or moderate hypertension were dual-blinded randomized into 3 groups. The range of blood pressure lowering, the time when the medicine began to work, the effective dose, safety and compliance were recorded. Results were compared between different groups to find an appropriate dose for clinical application. All the 126 patients did not use antihypertensive drugs and ran in for 2 weeks. They were randomized into 3 groups: enalapril 10mg+DHCT 6.25mg (group A), enalapril 10mg +DHCT12.5mg (group B), enalapril 10mg +placebo (group C). Each has 42cases. All the patients took 1 tablet at 7:00-10:00 every morning, and followed up at 8:00-10:00 every 2 weeks. After 4 weeks' therapy, the dosage was doubled in those whose diastolic blood pressure at sitting position were equal or higher than 90mmHg. All the patients did not use any other antihypertensive drugs during the study.In the end, 16 patients quitted,so we had 110 patients with complete data,among which there were 54 males and 56 females,with mean age of 56.51±8.18 yesrs. We performed blood, urine, blood chemistry and ECG examination in patients before and after the trial and no difference was found. No difference in bsaeline characters including age, sex, BMI, heart rate and blood pressure was found. So the three groups were comparable. After 2 weeks'therapy, the total response rate was 64.3%, 77.1%, 39.4%, with a markedly effective rate of 60.0%, 54.3%, 24.2% respectively. Group A and group B were better than group C (P<0.05). There were no difference between group A and group B (P>.05). After 4 weeks'therapy, the total response rate was 64.3%, 74.3%, 42.4%, with a markedly effective rate of 61.9%, 65.7%, 39.4% respectively. After 6 weeks'therapy, the total response rate was 90.5%, 85.7%, 72.7%, with a markedly effective rate of 80.9%, 82.9%, 66.7% respectively. After 8 weeks' therapy, the total response rate was 90.5%, 85.7%, 72.7%, with a...
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