Efficacy Of Enalapril-folic Acid Intervention Among Adults With H-type Hypertension In Shanxi Province

Objective:To find out distribution of serum homocysteine and efficacy of enalapril-folic acid intervention among people with H-type hypertension in Shanxi province.Methods:1207 cases with H-type hypertension were selected from Taiyuan, Lvliang, Yangquan,Xinzhou, Yuncheng as subjects from January, 2013 to August, 2015, and their distribution characteristic of serum homocysteine were analyzed. Dividing the subjects into two groups:enalapril-folic acid group and control group. Enalapril-folic acid group received enalapril-folic acid for hypertension, while control group took others. Blood pressure,serum homocysteine as well as ischemic stroke events were recorded at the 3rd, 6th,,12 th,18th and 24 th month of treatment.Results:The baseline levels of serum homocysteine in males and females were 22.00 μmol/L and 19.55μmol/L(P<0.05) respectively. Subjects were divided into three groups according to their age: the youth(18-44 years old), middle-aged(45-59 years old) and older(60-93 years old) group, among which there was no significant difference of serum homocysteine levels(P>0.05).When compared among cities, subjects from Yuncheng had the highest level of serum homocysteine(P<0.05), followed by Lvliang, Taiyuan, Yangquan and Xinzhou in order(P>0.05). After 2 years of Enalapril-folic acid tablet therapy, the blood pressure level and the blood serum homocysteine level in the enalapril-folic acid group were decreased significantly as compared with that before treatment(P<0.05), and the SBP was(128±8) vs(149±16) mm Hg, the DBP was(80±9) vs(89±13) mm Hg,the blood serum homocysteine level were11.90 vs 21.70 μmol/L. The blood pressure level in control group were decreased significantly as compared with that before treatment(P<0.05),and the SBP was(128±8) vs(149±16) mm Hg, the DBP was(80±9) vs(89±13) mm Hg, the blood serum homocysteine level was 20.10 vs 20.40 μmol/L(P>0.05)and the difference was insignificant. This means that there is no statistical difference in terms of antihypertensive method between two groups after two years treatment, the serum homocysteine level in the enalapril-folic acid group is much lower(P<0.05). During two years of follow-up, 14 cases(2.42%) in control group and 5(0.91%) in the enalapril-folic acid group were dead of ischemic stroke, which indicated that ischemic stroke events happened much less in the enalapril-folic acid group(P<0.05).Conclusion:The serum homocysteine level of H-type hypertension patients in Shanxi province could have gender and regional differences. The enalapril-folic acid tablets appeared to have a better efficacy in reducing serum homocysteine and preventing ischemic stroke for people with H-type hypertension.