Effect observation of amlodipine combined with losartan potassium hydrochlorothiazide in the treatment of refractory hypertension and its influence on atherosclerosis
Objective To observe the effect of amlodipine combined with losartan potassium hydrochlorothiazide in the treatment of refractory hypertension and its influence on atherosclerosis.Methods 60 patients with refractory hypertension were randomly divided into a control group(30 cases)and an observation group(30 cases).The control group was treated with amlodipine,and the observation group was treated with amlodipine and losartan potassium hydrochlorothiazide.The clinical symptom score,blood pressure level,vascular endothelial function,atherosclerosis and prognosis quality were compared between the two groups before and after treatment.Results After treatment,the scores of headache,vertigo and chest tightness in both groups were lower than those before treatment;the observation group had headache score of(1.47±0.52)points,vertigo score of(1.54±0.63)points and chest tightness score of(1.27±0.30)points,which were lower than(2.43±0.69),(2.33±0.81)and(2.14±0.48)points in the control group(P<0.05).After treatment,the 24 h systolic blood pressure,24 h diastolic blood pressure and mean arterial pressure in both groups were lower than those before treatment;the observation group had 24 h systolic blood pressure of(121.50±17.39)mm Hg(1 mm Hg= 0.133 kPa),24 h diastolic blood pressure of(85.71±9.51)mm Hg and mean arterial pressure of(108.87±5.15)mm Hg,which were lower than(136.11±18.04),(97.00±11.70)and(123.60±6.74)mm Hg in the control group(P<0.05).After treatment,the level of nitric oxide in both groups was higher than that before treatment,and the level of vascular endothelial growth factor was lower than that before treatment;the observation group had higher nitric oxide of(43.92±4.36)μmol/L than(34.41±5.50)μmol/L in the control group,and lower vascular endothelial growth factor of(143.21±20.17)ng/L than(156.60±29.70)ng/L in the control group(P<0.05).After treatment,the carotid intima-media thickness(IMT),carotid pulse index and carotid plaque area in both groups were better than those before treatment,and the observation group was better than the control group(P<0.05).After treatment,IMT,carotid pulse index and carotid plaque area in both groups were better than those before treatment;the observation group had IMT of(0.80±0.10)mm,carotid pulse index of(0.65±0.30)and carotid plaque area of(19.58±2.39)mm2,which were better than(1.03±0.22)mm,(0.98±0.44)and(25.47±3.31)mm2 in the control group(P<0.05).After treatment,the scores of physical function,social function,specific modules and treatment side effects in both groups were higher than those before treatment,and the observation group was higher than the control group(P<0.05).Conclusion Amlodipine combined with losartan potassium hydrochlorothiazide can improve the antihypertensive effect and improve the atherosclerosis of patients with refractory hypertension,which may be related to the combination of this program can improve vascular endothelial function and regulate blood pressure.
NETL
NSTL
万方数据
