The Effect of a Losartan-Based Treatment Regimen on Isolated Systolic Hypertension
作者:William C. Cushman、William E. Brady、Lisa P. Gazdick、Robert K. Zeldin
DOI:10.1111/j.1524-6175.2001.01481.x
日期:2002.3
This study was conducted to compare the antihypertensive efficacy and tolerability, over 12 weeks, of a losartan‐based treatment regimen and placebo in patients with isolated systolic hypertension. Three hundred eight patients ≥35 years of age with isolated systolic hypertension, defined as trough sitting blood pressure between 140 and 200 mm Hg systolic and between 70 and 89 mm Hg diastolic, were randomized to losartan 50 mg (n=157) or placebo (n=151) once daily, with titration as necessary to achieve a goal trough sitting systolic blood pressure (SBP) <140 mm Hg. At baseline, mean trough sitting SBP was 140–159 mm Hg in 20.5% of patients, 160–179 mm Hg in 62.7%, and 180–200 mm Hg in 16.9%, and was similar in the two groups (losartan, 165.3 mm Hg; placebo, 166.1 mm Hg). At 12 weeks, mean trough sitting SBP decreased significantly (p<0.001) in both the losartan‐based treatment group (by 19.2 mm Hg) and in the placebo group (by 7.6 mm Hg). The reduction in sitting SBP was significantly greater for losartan than placebo (−11.6 mm Hg; 95% confidence interval, −14.8 to −8.4). In patients with isolated systolic hypertension, a once‐daily losartan‐based treatment regimen significantly lowered SBP. The losartan‐based regimen exhibited antihypertensive efficacy that was superior to that of placebo, with a similar tolerability profile.
本研究旨在比较氯沙坦为基础的治疗方案与安慰剂在孤立性收缩期高血压患者中,12周内的抗高血压疗效及耐受性。纳入标准为35岁及以上,孤立性收缩期高血压患者,定义为坐位谷值血压收缩压在140至200 mm Hg之间,舒张压在70至89 mm Hg之间。308名患者按1:1随机分配至氯沙坦50 mg组(n=157)或安慰剂组(n=151),每日一次,根据需要调整剂量以达到目标坐位谷值收缩压(SBP)<140 mm Hg。基线时,20.5%患者的坐位谷值SBP为140–159 mm Hg,62.7%为160–179 mm Hg,16.9%为180–200 mm Hg,两组基线SBP相似(氯沙坦组165.3 mm Hg,安慰剂组166.1 mm Hg)。12周时,两组的坐位谷值SBP均显著降低(p<0.001),氯沙坦组降低19.2 mm Hg,安慰剂组降低7.6 mm Hg。与安慰剂相比,氯沙坦的坐位SBP降低幅度显著更大(−11.6 mm Hg;95%置信区间,−14.8至−8.4)。在孤立性收缩期高血压患者中,每日一次的氯沙坦为基础的治疗方案显著降低SBP。氯沙坦为基础的方案在抗高血压疗效上优于安慰剂,且耐受性相似。