Comparative Study About Effect Of Different Antihypertensive Programs On Blood Pressure And Inflammation Factors In Patients With Moderate-severe Hypertension

Objectives:To evaluate the level of plasma hypersensitive C-reactive protein(Hs-CRP), soluble intercellular adhesion molecule-1(sICAM-1) in Moderate-severe essential hypertension, and study the effects of Irbesartan/dihydrochlorothiazide(Irbesartan/DHCT) versus Irbesartan plus Amlodipine(Irbesartan+AML) on blood pressure and the levels of Hs-CRP、sICAM-1.The safety of Irbesartan/DHCT and irbesartan+AML were assessed after8-week treatment.Methods:A total of sixty-three patients of moderate-severe hypertensive patients was randomly assigned to Irbesartan/DHCT fixed-compound combination(group A) or Irbesartan plus AML prescription combination (group B). Fifteen patients of group A and seventeen patients of group B accomplished eight weeks follow-up, baseline and after treatment mean sitting blood pressure were examined, and the concentrations of plasma Hs-CRP and sICAM-1were detected respectively. Meanwhile eighteen normal subjects were selected as control.Results:1.The concentrations of Hs-CRP and sICAM-1in hypertensive patients were significantly higher than those in control (all P<0.05). 2.In the Irbesartan/DHCT fixed-compound combination(group A) and Irbesartan plus AML prescription combination (B group), mean sitting systolic pressure、diastolic pressure and pulse pressure were decreased markedly after8weeks(all p<0.05), the decline of mean sitting systolic pressure was more significant in group B than in the A group(p<0.05).3.The concentrations of Hs-CRP and sICAM-1were decreased markedly after therapy in group A and B, The variation of the Hs-CRP level had no difference between two groups (P>0.05),but the decline of sICAM-1level was more significant in B group than in group A (p<0.05).4.The level of hemoglobin was decreased after treatment with Irbesartan plus AML, but in the normal range. No significant changes of heart rate(HR),liver function,renal function,blood Lipid, electrolyte and fasting blood sugar (FBS) was found in both A and B group.5.In group B,one patient withdrew from the study because of obviously malaise; in the A group, one patient didn’t achieve the blood pressure goal after8weeks treatment and withdrew from the study. The side effects of both A and B group were very mild, the compliance of patients was very well.Conclusions: l.The concentrations of Hs-CRP and sICAM-1in hypertensive patients were significantly higher than those in normal control group.2.Both Irbesartan/DHCT fixed-compound combination and Irbesartan plus AML prescription combination treatment can effectively reduce SBP, DBP and PP, and Irbesartan plus AML prescription combination reduce the SBP more effectively.3.Both Irbesartan/DHCT fixed-compound combination and Irbesar-tan plus AML prescription combination treatment can markedly reduce the levels of Hs-CRP and sICAM-1in the hypertensive patients, and Irbesartan plus AML prescription combination reduce the sICAM-1more effectively, suggesting that both antihypertensive programs have anti-inflammatory effect.4. Both antihypertensive programs were relatively safe and the side effects were rare.