主页 > 医学动态 >
【文摘发布】无论使用何种抗高血压药物降低血
Author: Dr Scott D Solomon MD , Rajesh Janardhanan MD , Anil Verma MD , et al
Resource: The Lancet 2007; 369:2079-2087
Summary
Background
Diastolic dysfunction might represent an important pathophysiological intermediate between hypertension and heart failure. Our aim was to determine whether inhibitors of the renin-angiotensin-aldosterone system, which can reduce ventricular hypertrophy and myocardial fibrosis, can improve diastolic function to a greater extent than can other antihypertensive agents.
Methods
Patients with hypertension and evidence of diastolic dysfunction were randomly assigned to receive either the angiotensin receptor blocker valsartan (titrated to 320 mg once daily) or matched placebo. Patients in both groups also received concomitant antihypertensive agents that did not inhibit the renin-angiotensin system to reach targets of under 135 mm Hg systolic blood pressure and under 80 mm Hg diastolic blood pressure. The primary endpoint was change in diastolic relaxation velocity between baseline and 38 weeks as determined by tissue doppler imaging. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00170924.
Findings
186 patients were randomly assigned to receive valsartan; 198 were randomly assigned to receive placebo. 43 patients were lost to follow-up or discontinued the assigned intervention. Over 38 weeks, there was a 12·8 (SD 17·2)/7·1 (9·9) mm Hg reduction in blood pressure in the valsartan group and a 9·7 (17·0)/5·5 (10·2) mm Hg reduction in the placebo group. The difference in blood pressure reduction between the two groups was not significant. Diastolic relaxation velocity increased by 0·60 (SD 1·4) cm/s from baseline in the valsartan group (p<0·0001) and 0·44 (1·4) cm/s from baseline in the placebo group (p<0·0001) by week 38. However, there was no significant difference in the change in diastolic relaxation velocity between the groups (p=0·29).
Interpretation
Lowering blood pressure improves diastolic function irrespective of the type of antihypertensive agent used. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title: Effect of angiotensin receptor blockade and antihypertensive drugs on diastolic function in patients with hypertension and diastolic dysfunction: a randomised trial
标题：封闭血管紧张素受体和服用降血压药物对高血压和心脏舒张功能紊乱患者心脏舒张功能的作用：一项随机试验
Author: Dr Scott D Solomon MD , Rajesh Janardhanan MD , Anil Verma MD , et al
Resource: The Lancet 2007; 369:2079-2087
Summary
摘要
Background
背景
Diastolic dysfunction might represent an important pathophysiological intermediate between hypertension and heart failure. Our aim was to determine whether inhibitors of the renin-angiotensin-aldosterone system, which can reduce ventricular hypertrophy and myocardial fibrosis, can improve diastolic function to a greater extent than can other antihypertensive agents.
心脏舒张功能紊乱可能是从高血压进展到心脏病过程中的一个重要病生学过渡阶段的表现。肾素-血管紧张素-醛固酮系统可以减小心室肥大和减少心肌纤维化，我们的目的就是确定这一系统的抑制剂是否比其它抗高血压药物能更好地改善心脏舒张功能。
Methods
方法
Patients with hypertension and evidence of diastolic dysfunction were randomly assigned to receive either the angiotensin receptor blocker valsartan (titrated to 320 mg once daily) or matched placebo. Patients in both groups also received concomitant antihypertensive agents that did not inhibit the renin-angiotensin system to reach targets of under 135 mm Hg systolic blood pressure and under 80 mm Hg diastolic blood pressure. The primary endpoint was change in diastolic relaxation velocity between baseline and 38 weeks as determined by tissue doppler imaging. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00170924.
将高血压和有心脏舒张功能紊乱迹象的患者随机分为两组：一组服用血管紧张素受体封闭剂缬沙坦（滴定到320mg，每天滴定一次），对照组服用安慰剂。两组患者均同时服用不抑制肾素-血管紧张素系统的抗高血压药物使收缩压低于135毫米汞柱，舒张压低于80毫米汞柱。第一个终点是用组织多普勒成像测定的基础值和38周的心肌舒缩速度的改变。ClinicalTrials.gov登记了这项试验，其编号为NCT00170924。
Findings
186 patients were randomly assigned to receive valsartan; 198 were randomly assigned to receive placebo. 43 patients were lost to follow-up or discontinued the assigned intervention. Over 38 weeks, there was a 12•8 (SD 17•2)/7•1 (9•9) mm Hg reduction in blood pressure in the valsartan group and a 9•7 (17•0)/5•5 (10•2) mm Hg reduction in the placebo group. The difference in blood pressure reduction between the two groups was not significant. Diastolic relaxation velocity increased by 0•60 (SD 1•4) cm/s from baseline in the valsartan group (p<0•0001) and 0•44 (1•4) cm/s from baseline in the placebo group (p<0•0001) by week 38. However, there was no significant difference in the change in diastolic relaxation velocity between the groups (p=0•29).
阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-03-11 05:12
医学,生命科学网