Clinical trial of ivabradine in the treatment of elderly hypertensive patients with heart failure
Objective To observe the clinical efficacy and safety of ivabredine tablets in the treatment of elderly patients with hypertension and heart failure.Methods Elderly patients with hypertension and heart failure were divided into control group and treatment group by cohort method.The control group received nifedipine controlled release tablets 30 mg per time,qd,orally+furosemide tablets 20 mg per time,qd,orally+digoxin tablets 0.5 mg per time,qd,orally.On the basis of control group,the treatment group received ivabradine 5 mg per time,bid,orally after meals.Two groups were treated for 24 weeks.The clinical efficacy,right atrial volume indexes,left ventricular ejection fraction(LVEF),serum N-terminal pro-B-type natriuretic peptide precursor(NT-proBNP)levels and safety were compared between two groups.Results Fifty-three cases were enrolled in the treatment group,45 cases were enrolled in the control group.After treatment,the total effective rates of the treatment and control groups were 88.68%(47 cases/53 cases)and 71.11%(32 cases/45 cases),with statistically significant difference(P<0.05).After treatment,the right atrial volume indexes of treatment and control groups were(35.48±6.17)and(29.88±5.38)mL·m-2;the LVEF were(50.51±7.02)%and(43.78±6.35)%;the levels of NT-proBNP were 214(155,379)and 212(167,458)ng·mL-1,respectively,and the differences were statistically significant(all P<0.05).The adverse drug reactions of two groups were nausea and vomiting,slow heart rate,rash and dizziness.The total incidences of adverse drug reactions in the treatment and control groups were 11.32%and 11.11%without significant difference(P>0.05).Conclusion Ivaframine tablets have a significant clinical efficacy in the treatment of elderly patients with hypertension and heart failure,without increasing the incidence of adverse drug reactions.