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題名 | Irbesartan/Hydrochlorothiazide Fixed Combination Therapy in Systemic Hypertension: An Open-Label Uncontrolled Trial=Irbesartan/Hydrochlorothiazide固定複方療法對高血壓之療效 |
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作者姓名(中文) | 黃耀星; 蔡坤炎; | 書刊名 | Medical Journal of South Taiwan |
卷期 | 7:2 2011.12[民100.12] |
頁次 | 頁70-78 |
分類號 | 418.221 |
關鍵詞 | IRB/HCTZ複方療法; 高血壓; 生理時鐘; Angiotensin ⅡAT1接受體抑制劑; 攜帶型自動血壓監測儀; Irbesartan/hydrochlorothiazide combitherapy; Hypertension; Circadian rhythm; Angiotensin II AT1 receptor blocker; Ambulatory blood pressure monitoring; |
語文 | 英文(English) |
中文摘要 | 目的:本研究旨在門診利用24小時攜帶型自動血壓監測儀(ABPM)探討IRB/HCTZ對國人輕中度高血壓24小時之降壓效果,而此方面國內報告甚少。方法:門診高血壓病患合於JNC VII之規範,則納入本研究。每位病人做二次24小時ABPM,如口服過抗血壓劑而降壓未達目標值,停藥1-2週後,做第一次治療前(Baseline)之ABPM,治療4-5週後,如DBP仍大於95mmHg,則IRB/HCTZ加倍(低劑量之2倍),共使用8週後做第二次ABPM。結果:共25人(平均54歲)進入研究,21人完成,4人不願意做第二次ABPM,但在門診追蹤。治療8週後,平均24小時血壓由治療前之148±14/92±9mmHg降至治療後之126±13/80±7(P值<0.001/0.001)平均使用劑量每天IRB/HCTZ各為186±56/16±5mg。平均白天(上午6點至下午6點)之血壓由150±14/94±9降至127±13/81±7mmHg(P值<0.001/0.001),夜間血壓由143±15/89±10降至123±18/80±11mmHg(P值<0.001/0.001)。與夜間血壓相比,白天之降壓較多,治療後24小時血壓有意義下降達22小時,而保持血壓之日夜變動生理曲線有類似之血壓變動標準差(18.5±3.4/16.0±3.0 vs 20.4±5/8.0±3mmHg)。平均心跳沒變化。副作用頭痛及頭暈各1人,但未因此而停服藥物。結論:一天一次之IRB/HCTZ固定劑量併用可有意義降低國人輕中度高血壓病人之血壓,達22小時之久,而日夜變動曲線不變,副作用可以接受。 |
英文摘要 | Objective: This open label, uncontrolled study was to assess 24-hour efficacy of once-daily combination of hydrochlorothiazide (HCTZ) plus irbesartan (IRB) in Taiwanese outpatient with mild-to-moderate HTN. Methods: Patients with pre-hypertension, stage I or II hypertension (HTN) (as defined by the Seventh Report of the National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, JNC VII) were eligible to participate. Twenty-four-hr ambulatory BP monitoring (ABPM) was performed twice in each patient before and after 8-weeks combitherapy. If supine DBP still>95 mmHg at week 4 or 5, the dose was up titrated to high-dose IRB/HCTZ 300 mg/25 mg once daily (or 2 tablets of low-dose combination), or based on the decrease of BP. Results: A total of 25 patients (mean age, 54 years) were enrolled; 21 completed the study. Mean 24-hr systolic/diastolic BP after IRB/HCTZ combitherapy was significantly decreased compared with baseline BP (126±13/80±7 vs 148±14/92±9 mmHg (p<0.001/0.001). Mean final dose of irbesartan /hydrochlorothiazide was 186±56/16±5mg daiy after 8 weeks of titration period. Mean daytime (6 A.M. to 6 P.M.) BP decreased from 150±14/94±9 to 127±13/ 81±7 mmHg, p<0.001/0.001. Nighttime (6 P.M. to 6 A.M.) BP decreased from 142±15/89±10 to 125±18/80±11mmHg, p<0.001/0.001). BP reduction was more pronounced during the day. After treatment, significant BP reduction was observed throughout 22 of the 24-hourly mean points. The circadian rhythm was preserved as indicated by similar BP standard deviations (18.5±3.4/16.0±3.0 vs 20.4±5/8.0±3.0 mmHg). Mean heart rate did not change. Two pts reported having dizziness and one frontal headache. Conclusions: Once-daily IRB/HCTZ combitherapy provided significant BP reduction throughout 22 of the 24 hourly mean points with preserved CR and was generally well tolerated in Taiwanese hypertension patients. |
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