The Influence To Pulse Pressure Of Antihypertension Therapy And The Relation With Stroke

ObjectiveFirstly, through this baseline investigation, researching the relations between different pulse pressure level and stroke; Secondly, setting up the non-strengthened treatment group and strengthening treatment group ,which gives hydrochlorothiazide, nitrendipine and captopril. The purpose is to be difenate the influence of the above three medicines on pulse pressure, and whether reducing pulse pressure can reduce the stroke. In order to provide the basis of best antihypertension therapy plan that suits our current countryside patients with hypertension.MethodsFrom July 2004 to December 2005, we carried out the questionnaire survey by centralism method in Fuxin rural areas , the Liaoning Province, recording the selected crowd's general condition (name, sex, age,etc),the stroke and so on in detail, measuring and recording the blood pressure. The whole patients with elevated blood pressure are the object of study who were divided into the non-strengthened treatment group and the strengthened treatment group by means of random sampling, according to inclusion and exclusion standard. The non-strengthened treatment group were treated with the life style intervention, while the strengthened treatment group were treated with hydrochlorothiazide.Every month,the blood pressure(BP) was measured again, nitrendipine 25 mg two times every day were given to those whose blood pressure didn't reach the standard.After one month, doubled nitrendipine gives were given to those whose blood pressure still didn't reach the standard. Another one month, those whose blood pressure still didn't reach the standard were given to captopril 25 mg two times every day. Investigating and recording the numbers of stoke. SPSS11.5 of statistical software was used and T-test, X2-test analysis were performed for Data analysis. ResultsThe baseline investigation altogether completes 41676 persons. After having adjusted other factors and the diastolic pressure, the stroke prevalence rate had the significant difference in pulse pressure 60～69mmHg and≥100mmHg group compareing with the 40～49mmHg group in the <60 years old crowd,; But after having adjusted the systolic pressure, there is a significant difference only in the 60～69mmHg group. After having adjusted other factors and the diastolic pressure, the stroke prevalence rate had the significance difference in pulse pressure 50～59mmHg,60～69mmHg,70～79mmHg,80～89mmHg and≥100mmHg group compareing with the 40～49mmHg group in the≥60 years old crowd,; But after having adjusted the systolic pressure, there is a significant difference only in the 60～69mmHg group.The Strengthened treatment group altogether completes 2371 patients with elevated blood pressure, non-strengthened treatment group altogether completes 2614 examples. The pulse pressure decreases average 8.18mmHg in the strengthened treatment group, and elevating 1.11mmHg in the non-strengthened treatment group. This phenomenon is more obvious in the≥60mmHg group, and there is a significant statistically difference compareing with the < 60mmHg group. The pulse pressure elevated more obvious in the non-strengthened treatment group compareing with the strengthened treatment group in <60mmHg group. The strokes were 26 examples in the strengthened treatment group, and 53 examples in the non-strengthened treatment group. There is a significant statistically difference between the two groups. In the≥60mmHg group the number is 20 to 38, and there is a significant statistically difference. But in the <60mmHg group the number is 6 to 15, there is a insignificant statistically difference.ConclusionThe SBP affects the senior deeply, but regardless of any age the grope pulse pressure in 60～69mmHg will dramatically increase stroke prevalence.The antihypertension therapy of uniting hydrochlorothiazide, nitrendipine and captopril can effectively decrease the pulse pressure. In low pulse pressure crowd, no matter treats or not,there is the tendency that pulse pressure increases with the growing age, but the antihypertension therapy of uniting hydrochlorothiazide, nitrendipine and captopril can decrease the tendency. The antihypertension therapy of uniting hydrochlorothiazide, nitrendipine and captoprihydrogen can reduce the occurrence of stroke, the high pulse pressure crowd obtains benefits more from the above treatment.