| Objective To compare the effects of sacubitril-valsartan and valsartan on ambulatory blood pressure,blood pressure variability and inflammatory factors in elderly patients with essential hypertension.Methods Elderly patients with essential hypertension who were hospitalized in the Affiliated Hospital of Qingdao University from July 1,2021 to July 1,2022 were selected.According to the patient’s taking antihypertensive drugs,it was divided into sacubitril-valsartan sodium(200 mg once a day))group and valsartan(160 mg once a day)group.After 8 weeks of treatment,the changes of blood pressure(mean sitting systolic blood pressure,mean sitting diastolic blood pressure,heart rate),ambulatory blood pressure(24h average systolic blood pressure,24 h average diastolic blood pressure,24 h average heart rate,day average systolic blood pressure,day average diastolic blood pressure,night average systolic blood pressure,night average diastolic blood pressure,morning blood pressure,morning blood pressure surge,24 h systolic blood pressure coefficient of variation,24 h coefficient of variation of diastolic blood pressure)and inflammatory factors[Interleukin(IL)-4,IL-6,IL-8,IL-10,IL-17,IL-1β,IL-2,IL-5,tumor necrosis factor(TNF)-α]were observed in the two groups.Results A total of 215 elderly patients with essential hypertension were included in this study.There were 104 patients(48.37%)in the Sacubitril-Valsartan group and 111patients(51.63%)in the valsartan group.Age range: 65-85(72.38±6.95)years;There were117 males(54.42%)and 98 females(53.44%).Before treatment,there were no significant differences in gender,age,body mass index,course of hypertension,hypertension grade,cardiovascular risk stratification in hypertensive patients,comorbidities,biochemical indexes,smoking history,family history,clinical combined medication,blood pressure,ambulatory blood pressure,and inflammatory factor levels between the two groups(P>0.05).Compared with before admission,the difference in office blood pressure and heart rate reduction,ambulatory blood pressure and ambulatory heart rate reduction,and blood pressure variability improvement between the two groups after 8 weeks of treatment was statistically significant(P<0.05),after 8 weeks of treatment between the two groups,the difference in office blood pressure,office heart rate,ambulatory blood pressure,ambulatory heart rate,blood pressure variability index,and the attainment rate of office blood pressure and ambulatory blood pressure in the sacubitril-valsartan group were statistically significant compared with the valsartan group.Compared with before treatment,there were statistically significant differences in IL-1β,IL-6,IL-10,IL-17 and TNF-α between the two groups after 8 weeks of treatment(P <0.05).After 8 weeks of treatment,the levels of pro-inflammatory factors(IL-1β,IL-6,IL-17,TNF-α)in the two groups were lower than those before treatment,and the level of anti-inflammatory factor(IL-10)was higher than that before treatment(P < 0.05).The decrease of IL-17 and the increase of IL-10 in Sacubitril-Valsartan sodium group were more significant than those in valsartan group(P < 0.05).Conclusion Sacubitril-Valsartan sodium can better improve blood pressure variability in elderly patients with essential hypertension.The mechanism of which may be related to the reduction of the level of pro-inflammatory factor(IL-17)and the increase of the level of anti-inflammatory factor(IL-10). |
