| Hypertension is one of the most common cardiovascular diseases, which is alsoone important risk factor of stroke, myocardial infarction, heart failure and chronickidney disease. Drug therapy plays a decisive role in the treatment of hypertension.Relevant researches show that some of the hypertensions take one antihypertensivealone cannot control the blood pressure satisfactorily, so they need two or moredrugs combined. At present, a number of small-scale clinical trials confirm that theantihypertensive No.0has good efficacy and safety, but its application lacks ofrelated research about the long-term efficacy and safety. Therefore, in order tofurther understand the safety, long-term efficacy, and patients’ satisfaction of thisdrug, we study the long-term follow-up of hypertensions in communities of Daqingcity, Heilongjiang Province in this research.ObjectivesEvaluate the long-term efficacy and safety of the antihypertensive No.0drug inthe treatment, and to understand patients’ satisfaction and provide moreadequate,reliable evidences for the reasonable application of this drug.MethodsThe definition and classification of hypertension diagnosis standard wasaccording to the "Guidelines for Prevention and Treatment of Hypertension in China(2005Edition)", and we selected406cases of35to74years old diagnosed primaryhypertensions as research object in Honggang District and Ranghulu District,Daqing, Heilongjiang in2009November, then divided them into theantihypertensive No.0group and the routine treatment group according to thedisease severity and patients’ medication willingness. The first group tookantihypertensive No.0from Beijing Shuanghe pharmaceutical according to severity, 1tablet each time, once daily generally; while the second group took other routineantihypertensive drugs. After drug dosage adjustment was stable, we took follow-upstudy on those patients for3years. The database established by Epidata3.0,statistical analysis by SPSS17.0. The measurement data was represented by X±S orM±Q, and compared by T test or Z test; count data was represented by rate, andcompared by χ2test.Results1. The study subjects were406cases, of which400cases completed the3yearsof follow-up study. After3years, systolic and diastolic blood pressure decreased7.76mmHg and8.69mmHg respectively in the No.0group, compared with5.33mmHg and1.16mmHg in another group. The systolic and diastolic bloodpressure of the both two groups was decreased compared with the data beforefollow-up. After3years of follow-up, the No.0groups’ antihypertensive efficiencywas96.04%(194/202), slightly higher than that of the routine treatment group(87.98%)(χ2=9.048,P=0.003).2. After3years of follow-up, the abnormal rate of cardiac function in patientsof No.0group was increased to24.75%(50/202) from21.78%(44/202), and nodifferences compared with the data before follow-up(χ2=0.674,P=0.412). The No.0group’s proportion of left ventricular hypertensions reduced to4%(2/50) from47.73%(21/44), while the abnormal heart function rate of the routine treatmentgroup had increased to23.74%(47/198) from12.12%(24/198). The differences hadstatistically significant (χ2=9.078,P=0.003).The cholesterol and triglyceride of No.0group had increased(0.61±1.16) and(0.66±1.05)mmol/L respectively, and the rate of abnormal cholesterol metabolismincreased from5.45%(11/202) to20.79%(42/202), the rate of abnormal triglyceridemetabolism increased from15.84%(32/202) to62.38%(126/202);cholesterol/triglyceride of the routine treatment group increased(0.55±1.19)/(0.87±1.22)mmol/L. The rate of abnormal cholesterol and triglyceridemetabolism increased from8.08%(16/198) to16.67%(33/198), and from 15.66%(31/198) to45.46%(90/198) respectively. The rangeability and metabolismabnormal rate of cholesterol and triglyceride are increased in both the twogroups(P<0.05).After3years of follow-up, the blood glucose raised (0.70±1.10)mmol/L, andthe abnormal metabolism rate of No.0group increased from16.34%(33/202) to35.64%(72/202) respectively, compared with the routine treatment group(0.90±1.00)mmol/L and24.75%(from14.65%) respectively. The blood glucose leveland abnormal metabolic rates of both the two groups all increased(P<0.05).Followed up for3years, the level and the abnormal metabolism rate ofaspartate transaminase of No.0group’s hypertensions decreased (1.50±16)U/L andincreased to3.96%(from3.47%) respectively, compared with alanineaminotransferase of (1.25±11.00)U/L and4.95%(from2.97%). The results of beforeand after follow-up showed no significant difference(P>0.05). In the routinetreatment group, aspartate transaminase level and abnormal metabolism rate raised(1.00±14.00)U/L and to1.52%(from0), compared with alanine aminotransferaselevel and abnormal metabolism rate raised (2.00±12.00)U/L and to2.02%(from0).The aspartate transaminase and alanine transaminase has changed afterfollow-up(P<0.05), while metabolic abnormality rate had no differences(P>0.05).We took further study on the gender and age stratification of the No.0group, theresults showed that alanine aminotransferase levels in male hypertensions havechanged after follow-up(z=2.159, P=0.033); alanine aminotransferase level of60-age group was different(z=2.101, P=0.035).The ZUNG’s Depression Scale study showed that there was no depressionpatient in the both groups after follow-up. The ZUNG’s Depression Scale score ofNo.0group increased (8.50±4.00), compared with (7.00±5.00) of the routinetreatment group. The total scores of the two groups were all increased comparedwith the scores before follow-up(P<0.05).The result of the international index of erectile function questionnaire showedthat the patients of both the two groups had no erectile dysfunction before and after follow-up, and no differences between the two groups.3. The research of drug satisfaction showed that the patients of the two groupsall satisfied with the therapeutic effect, adverse reactions and cost. In terms ofefficacy,99.50%(201/202) of the patients in No.0group satisfied with the efficacycompared with98.49%(195/198) in the routine treatment group, and no differencesin the two groups (χ2=1.369, P=0.242). The patients of the No.0group cost anaverage of26.43±8.16RMB per month, compared with26.47±14.42RMB permonth of the routine treatment group, and no significant differences in the twogroups. All the patients could accept the cost basically.Conclusions1. The antihypertensive No.0can reduce the blood pressure as well as otherantihypertensive drugs, but its long-term efficacy is slightly better.2. The antihypertensive No.0has no adverse effects on cardiac function inhypertensions, but has reversal effect on left ventricular hypertrophy; therangeability and metabolism abnormal rate of hypertensions’ cholesterol andtriglyceride in both the two groups are all increasing, as well as the blood glucoselevel and metabolism abnormal rate;The No.0has no effects on aspartatetransaminase,but has effect in male and60-age group hypertensions of alaninetransaminase; the No.0has no effects on the emotion of hypertensions and theerectile function of male patients.3. Essential hypertensions in communities basically satisfy with the efficacy,adverse reactions, cost and other aspects of the antihypertensive No.0. |
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