OBJECTIVE:The aim of the present study was to compare the effects of the combination of lercanidipine/enalapril versus amlodipine/enalapril and hydrochlorothiazide/enalapril on blood pressure, target organ damage and sympathetic activation in patients with grade 2 essential hypertension. RESEARCH DESIGN AND METHODS:This was a 3 month, randomized, blinded-endpoint study in essential hypertensive patients. MAIN OUTCOME MEASURES:Office and ambulatory blood pressure, arterial stiffness, urinary albumin to creatinine ratio, renal arterial resistive index, and muscle sympathetic nerve activity were evaluated at baseline, after a 2 week run-in placebo period, at 1 month and at 3 months. RESULTS:In total, 56 patients were assigned to lercanidipine/enalapril (n = 19), enalapril/amlodipine (n = 18) and hydrochlorothiazide/enalapril (n = 19). Each pharmacological combination tested was effective in reducing office blood pressure at 1 month and 3 months, and 24 h ambulatory blood pressure at 3 months. Renal arterial resistive index (RI) significantly improved at 1 month and 3 months compared with baseline in all groups. However in the lercanidipine/enalapril and hydrochlorothiazide/enalapril groups, RI was favorably reduced (0.53 ± 0.03 and 0.54 ± 0.04 respectively, p < 0.05) in comparison with the enalapril/amlodipine RI value (0.57 ± 0.03) at 3 months. Moreover, after 3 months of treatment, a significant decrease (by -5.47 bursts/min) (p < 0.05) in muscle sympathetic nerve activity was observed in the lercanidipine/enalapril group (50.79 ± 6.49) compared with baseline (56.26 ± 6.05), while no differences were detected in the amlodipine/enalapril and hydrochlorothiazide/enalapril groups. CONCLUSIONS:Our study provides evidence of the efficacy of the lercanidipine/enalapril combination in ameliorating hypertension-related target organ damage and in reducing sympathetic overdrive.

译文

目的:本研究的目的是比较乐卡地平/依那普利与氨氯地平/依那普利和氢氯噻嗪/依那普利联用对2级原发性高血压患者血压,靶器官损害和交感神经活化的影响。
研究设计与方法:这是一项为期3个月的针对原发性高血压患者的随机,盲目的盲点研究。
主要观察指标:在基线期,磨合期2周,1个月和3个月后,在基线时评估办公室和门诊血压,动脉僵硬度,尿白蛋白与肌酐之比,肾动脉抵抗指数和肌肉交感神经活动。个月。
结果:总共56例患者被分配为lercanidipine / enalapril(n = 19),enalapril / amlodipine(n = 18)和hydrochlorothiazide / enalapril(n assigned = 19)。所测试的每种药理组合在1个月和3个月时均可有效降低办公室血压,在3个月时可降低24小时动态血压。在所有组中,与基线相比,肾动脉阻力指数(RI)在1个月和3个月时均显着改善。然而,在3个月时,与依那普利/氨氯地平RI值(0.57±0.03)相比,在lercanidipine / enalapril和hydrochlorothiazide / enalapril组中,RI有利地降低(分别为0.53±0.03和0.54±0.04,p <0.05)。此外,治疗3个月后,乐卡地平/依那普利组(50.79±6.49)与基线(56.26 nerve±6.05)相比,肌肉交感神经活动显着下降(-5.47次/分钟)(p <0.05)。 ,而氨氯地平/依那普利和氢氯噻嗪/依那普利组未见差异。
结论:我们的研究提供了乐卡地平/依那普利组合在减轻高血压相关靶器官损害和减少交感神经过度驱动方面的功效的证据。

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