| Objective: In this research, the effect of β-blockers /diuretics treating elderly patients with systolic hypertension(ISH) were compare to routine treatment on clinical efficacy and the influence on pulse pressure(PP).Methods: Dated from October 2015 to January 2017, in the First Affiliated Hospital of Kunming Medical University, Department of Cardiology, 192 patients(95 men, 87 women, average age70.07±5.47) including ISH level 1 119 cases, ISH level 2 73 cases, were enrolled. All cases meets the criterion of Chinese Hypertension Prevention Guide 2010 and were divided into study group(95 cases) and control group(97 cases). There was no significant different in gender age, mean duration,blood glucose, blood lipid, serum potassium and other baseline data between the both groups. The study group was treated with hydrochlorothiazide tablets (12.5 mg/day)in the morning,and 2.5 mg/tablet of bisoprolol fumarate was administered once a day,the control group was treated with other first-line regimens except beta-blockers and diuretics Pressure. 24 hours mean systolic blood pressure (24hSBP), mean systolic blood pressure (dSBP), night mean systolic blood pressure (nSBP), 24h mean systolic blood pressure The mean diastolic blood pressure (dDBP), night mean diastolic blood pressure (nDBP), and 24 hour mean pulse pressure (24hPP) were texted before and after 6±0.45 months of treat between both groups, record the patient’s medication,adverse reactions and condition changes druing treatment. Data were analyzed by SPSS 19.0 statistical software, P<0.05 for the significant difference.Results:Both groups were accepted (6 ± 0.45) months treatment,the study group markedly effective 41 cases, effective 32 cases, ineffective 22 cases, the total effective rate was 76.84%, while the control group markedly effective 45 cases, effective 33 cases, ineffective 19 cases, the total effective rate of 80.41%. There was no significant difference between the both groups about 24 hours ambulatory blood pressure monitoring (24hABPM) realted indicators 24hSBP, dSBP, nSBP, 24hSBP, 24hDBP,dDBP, nDBP and 24hPP. The level to the study group:24hSBP (157.86±8.39mmHg vs 130.18±5.07mmHg P<0.001)、dSBP(165.50±8.62mmHg vs 135.22±7.78mmHg P<0.001)、nSBP (150.26±6.13mmHg vs 126.53±3.96mmHg P<0.001)、24hDBP(73.38±6.15mmHg vs 73.87±4.57mmHg P<0.001) 、 dDBP (79.40±6.32mmHg vs 77.57±6.31mmHg P<0.001)、nDBP(75.23±6.13mmHg vs 69.24±5.01mmHg P<0.001 )、24hPP ( 82.51±6.32mmHg vs 62.51±5.25mmHg P < 0.001 ) were significantly lower than before. The level to the control group:24hSBP(158.70±7.39mmHg vs 133.86±6.07mmHg P<0.001) 、 dSBP (156.86±7.07mmHg vs 140.422±8.18mmHg P<0.001)、nSBP (148.86±6.32mmHg vs 128.68±4.61mmHg P<0.001) 、 24hDBP (73.08±5.13mmHg vs 68.97±4.12mmHg P<0.001) 、 dDBP(76.40±5.32mmHg vs 73.57±5.37mmHg P<0.001) 、 nDBP (69.84±4.13mmHg vs 64.50±4.87mmHg P<0.001)、24hPP (81.52±5.87mmHg vs 70.01±6.25mmHgP<0.001 ) were significantly lower than before. Compared the 24hABPM indicator between study group and control group after treatment, there was no significant difference in 24hSBP, dSBPand nSBP, while the 24hDBP ( 73.87±4.57mmHg vs 68.97±4.12mmHg P=0.091 ) , dDBP ( 77.57±6.31mmHg vs 73.57±5.37mmHg P=0.119) , nDBP (69.24±5.01mmHg vs 64.50±4.87mmHg P=0.132) , 24hPP(62.51±5.25mmHg vs 70.01±6.25mmHg P=0.256) were significantly higher in the study group than in the control group. The total adverse reaction rate in the treatment group was 8.42%, the control group was 15.46%, which was significantly highter (P>0.05).Clusions: 1. Elderly patients with isolated systolic hypertension treated with hydrochlorothiazide combined with bisoprolol can achieved the compare effect with other therapies, but lower the adverse reactions include dizziness, facial flushing, and so on. 2. Hydrochlorothiazide combined with bisoprolol in elderly patients with simple systolic hypertension did not significantly lead to bradycardia, moreover, the effect of pulse pressure on patients was significantly less than other antihypertensive regimens... |
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