氨氯地平在接受缬沙坦治疗的高血压患者中附加治疗的有效性。

Derek Weycker, Abdulkadir Keskinaslan, Drew Griffin Levy, John Edelsberg, Alex Kartashov, Gerry Oster
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引用次数: 7

摘要

目的:描述氨氯地平加药治疗缬沙坦高血压患者的实际疗效。方法:基于美国电子病历的回顾性队列研究。研究人群包括1998年1月至2005年12月期间接受缬沙坦并随后开始氨氯地平辅助治疗的高血压患者。收缩压(SBP)/舒张压(DBP)的变化,以及收缩压/舒张压目标(即< 140/90 mmHg)的实现,根据开始使用氨氯地平后180天前的最后可用读数进行检查。结果:研究对象(n=155)的平均(+/- SD)基线收缩压/舒张压为152.5 (+/- 21.1)/84.0 (+/- 13.5)mmHg。附加治疗氨氯地平降低收缩压13.3 mmHg (95% CI 9.4-17.1),舒张压降低6.1 mmHg (95% CI 4.2-8.1)。在基线收缩压/舒张压>或= 160/100 mmHg的患者(n=69)中,相应的降低为28.8 mmHg (95% CI 23.4-34.2)和11.4 mmHg (95% CI 8.4-14.3)。46%的受试者达到收缩压/舒张压目标(95% CI 37.7-55.6);患有和不患有糖尿病或慢性肾脏疾病的患者,以及年龄>或= 65岁的患者与更年轻的患者的目标达成率相似。结论:缬沙坦联合氨氯地平治疗高血压,总体上和高危亚组可能从血压控制中获益最多,结果具有临床意义的血压降低。
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Effectiveness of add-on therapy with amlodipine in hypertensive patients receiving valsartan.

Objective: To describe the real-world effectiveness of amlodipine add-on therapy for hypertensive patients receiving valsartan.

Methods: Retrospective cohort study based on USA electronic medical records. The study population included hypertensive patients who, between January 1998 and December 2005, were receiving valsartan and subsequently initiated add-on therapy with amlodipine. Change in systolic blood pressure (SBP)/diastolic blood pressure (DBP), and attainment of goal SBP/DBP (i.e. < 140/90 mmHg), were examined based on last available reading prior to day 180 following initiation of amlodipine.

Results: Mean (+/- SD) baseline SBP/DBP of study subjects (n=155) was 152.5 (+/- 21.1)/84.0 (+/- 13.5) mmHg. Add-on therapy with amlodipine reduced SBP by 13.3 mmHg (95% CI 9.4-17.1) and DBP by 6.1 mmHg (95% CI 4.2-8.1). Among patients with baseline SBP/DBP > or = 160/100 mmHg (n=69), corresponding reductions were 28.8 mmHg (95% CI 23.4-34.2) and 11.4 mmHg (95% CI 8.4-14.3). Goal SBP/DBP was achieved by 46% (95% CI 37.7-55.6) of subjects; rates of goal attainment were similar for patients with and without diabetes or chronic kidney disease, and those aged > or = 65 years versus younger.

Conclusions: Adding amlodipine to valsartan for treatment of hypertension results in clinically meaningful reductions in blood pressure, on an overall basis and in high-risk subgroups who may benefit the most from blood pressure control.

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Post-registration studies for the evaluation of antihypertensive drugs. Effect of fixed dose combinations of metoprolol and amlodipine in essential hypertension: MARS--a randomized controlled trial. Efficacy and safety of valsartan in hypertensive Taiwanese patients: post-marketing surveillance study. Efficacy and safety of early versus late titration of fixed-dose irbesartan/hydrochlorothiazide: ACTUAL study. Clevidipine for severe hypertension in patients with renal dysfunction: a VELOCITY trial analysis.
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