The Clinical Efficacy Of Bisoprolol In Treatment Of Hypertension With Coronary Heart Disease

Background Bisoprolol is a highly selective antagonist to beta 1 receptor,which can not only slow heart rate and inhibit myocardial contractility by blocking the beta 1 receptor of heart,but also reduce the release of rennin.So it is always used to treat hypertension and coronary heart disease in clinical practice.Before treating,we analysed the correlation between heart rate,blood pressure and catecholamine levels in 120 cases of hypertensions in our hospital.After the basic treatment or bisoprolol treatment,we analysed the changes of heart rate,blood pressure,plasma catecholamine level,indicators of heart failure,left ventricular remodeling index.The curative effect to hypertensions,with different heart rate,catecholamine level and subtypes of coronary heart disease,was analysed at the same time.All of which can provide a theoretical basis for the mechanism of bisoprolol to treat hypertension with coronary heart disease.Objective We aimed to analyse the correlation between heart rate,catecholamine levels and blood pressure in 120 cases of hypertensions in our hospital.After a long term treatment of bisoprolol,we analysed the changes of heart rate,blood pressure,plasma catecholamine level,indicators of heart failure,left ventricular remodeling index and the curative effect to hypertensions with different heart rate,catecholamine level and coronary heart disease.All of them can provide a theoretical basis for the mechanism of bisoprolol to treat hypertension with coronary heart disease.Methods 1.Subjects investigated: From March 2014 to March 2015,120 patients were equally divided into basic treatment group and bisoprolol treatment group,which were diagnosed hypertension by the Department of Cardiology of the Central Hospital of Zhumadian city.2.Data collection: Sex,age,hypertension,coronary heart disease were collected prior to admission.Follow up blood pressure,heart rate,catecholamine levels,heart failure index,inflammation index,left ventricular remodeling index,etc.after treatment.3.Measurement data with standard deviation of mean and subtract(mean±SD),compare the difference between the two groups using t test,the data were compared by chi-square test.Inspection level of alpha = 0.05,P < 0.05 for the difference was statistically.Results 1.Before the treatment,age,gender,heart rate,blood pressure,catecholamines,indicators of heart failure and left ventricular remodeling had no significant difference between basic treatment group and bisoprolol treatment group;2.Hypertension patients with MAP and SBP values were correlated with NE and E values respectively,DBP and MAP were correlated with HR,NE and E values were correlated with HR;3.Compared with un-treatment,the reduced value of heart rate in bisoprolol treatment group was(16.9±2.1)beats/min,higher than the reduced value in base treatment group(10.±1.9)beats/min,and there was significant difference;4.Compared with un-treatment,the reduced value of NE concentration in bisoprolol treatment group was(111.0±24.1)n/L,higher than the reduced value in base treatment group(66.8±14.7)ng/L;the reduced value of E concentration in bisoprolol treatment group was(70.4±16.2)ng/L,higher than the c reduced value in base treatment group(5.55±13.7)ng/L;the reduced value of BNP in bisoprolol treatment group was(810.6±159.3)ng/L,higher than the reduced value in base treatment group(611.7±210.0)ng/L,there were significant differences;5.Compared with un-treatment,the change of echocardiography detection index LVEF%,LVMI and RWT in bisoprolol treatment group was higher than that in base treatment group,and there were significant differences;6.In bisoprolol group,the total effective rate of abnormal heart rate group was 96.2%,higher than that in the normal heart rate group;the total effective rate of abnormal catecholamine levels group was 90.6%,higher than that in the normal catecholamine levels group;the total effective rate of hypertension without complication group was 90.2%,higher than that in hypertensive patients with occult coronary heart disease group,and there were significant differences.Conclusions 1.Bisoprolol lowers blood pressure and inhibits left ventricular remodeling mainly through inhibition of heart rate and plasma catecholamines in patients with hypertension;2.Patients with high heart rate and catecholamine levels are more sensitive bisoprolol,but patients with latent coronary heart disease is not.