Effect of benazepril combined with amlodipine on intestinal microecology in patients with essential hypertension
Objective To explore the efficacy of benazepril combined with amlodipine in treatment of patients with essential hypertension and its impact on intestinal microecology of the patients.Methods A total of 165 patients with essential hyperten-sion treated in Zhengzhou Seventh People's Hospital from March 2020 to March 2023 were enrolled in this study and divided into the control group(n=83,treated with amlodipine)and the observation group(n=82,treated with benazepril and amlodipine).The 24 h mean blood pressure(systolic and diastolic blood pressure),lipid metabolism(triglyceride(TG),total cholesterol(TC)),endothelial function(endothelin-1(ET-1),nitric oxide(NO)),inflammatory factors(tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP))and intestinal microecology(changes of intestinal flora(Bacteroides,Lactobacillus,Enterococcus)),species diversity and richness indexes(Shannon index,Ace index,Chaol index))were compared between the two groups before and after treatment.The rate of adverse reactions was calculated in both groups.Results After treatment,the systolic blood pressure((121.67±12.54)mm Hg(1 mm Hg≈0.133 kPa)vs(132.85±14.38)mm Hg(1 mm Hg≈0.133 kPa))and the diastolic blood pressure((72.21±8.34)mm Hg vs(83.74±9.57)mm Hg)in the observation group were both lower than those of the control group(t=5.320,8.246,both P<0.001).The lipid metabolism indicators in the observation group were lower than that in the control group(serum TG(1.24±0.21)mmol∙L-1 vs(1.56±0.28)mmol·L-1,serum TC(3.47±0.62)mmol∙L-1 vs(4.23±0.76)mmol∙L-1,t=3.111,7.034,both P<0.05).The levels of serum ET-1,CRP,IL-6,and TNF-α in the observation group were lower than those in the control group(t=5.567,8.408,4.864,7.215,all P<0.05).The relative abundance of Firmicutes and Proteobacteria((15.36±2.43)%vs(16.19±2.11)%,(3.42±1.01)%vs(3.96±0.96)%,t=2.344,3.520,both P<0.05),as well as the number of Escherichia coli and Enterococ-cus((8.22±1.36)log10 CFU·g-1 vs(9.16±1.45)log10 CFU·g-1,(7.87±0.96)log10 CFU·g-1 vs(8.59±1.18)log10 CFU·g-1,t=4.294,4.296,both P<0.05)in the observation group were all lower than those in the control group.After treatment,the serum NO level in the ob-servation group was higher than that in the control group((46.12±8.53)μmol·L-1 vs(35.49±7.45)μmol·L-1,t=8.529,P<0.05).The observation group showed higher levels of Bacteroides((10.23±1.55)μmol·L-1 vs(9.15±1.42)μmol·L-1),Lactobacillus((6.82±1.28)μmol·L-1 vs(6.05±1.16)μmol·L-1),Ace index((556.29±86.43)vs(475.35±75.68)),Chao l index((586.67±81.64)vs(493.45±72.34)),and Shannon index((6.28±1.16)vs(5.58±0.95))as compared with the control group(t=4.668,4.050,6.402,7.765,4.243,all P<0.05).Conclusion Benazepril combined with amlodipine in the treatment of patients with essential hypertension can ob-viously reduce blood pressure and blood lipid levels,improve endothelial function,inhibit inflammatory reaction and regulate intestinal mi-cro-ecological environment.Meanwhile,it is of high safety.
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