Efficacy of sacubitril valsartan in treatment of hypertension and chronic heart failure in elderly patients
Objective To investigate the clinical efficacy of sacubitril/valsartan sodium tablets(SVST)combined with me-toprolol in elderly patients with hypertension and chronic heart failure(CHF).Methods Ninety-four elderly patients with hyper-tension and CHF admitted to the First People's Hospital of Linping District,Hangzhou,from June 2023 to March 2024 were se-lected and randomly grouped,with 47 in each group.The patients in the control group were treated with metoprolol while those in the observation group with SVST on the basis of metoprolol.Treatment in both groups lasted for 3 months.The effectiveness of treatment,serum-related factors(serum homocysteine(Hcy),interleukin-6(IL-6),N-terminal pro-brain natriuretic peptide(NT-proB-NP)),and cardiac function indicators were compared between the two groups.The cardiac function indicators included left ventric-ular end-systolic diameter(LEVSD),left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF).Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(91.48%(43/47)vs 74.46%(35/47),χ2=4.821,P＜0.05).After treatment,the levels of serum-related factors Hcy,IL-6,and NT-proBNP in both groups were all significantly lower than those before treatment(all P＜0.05).The levels of serum Hcy,IL-6 and NT-proBNP were significantly lower in the observation group than in the control((14.53±2.18)μmol·L-1 vs(15.71±2.28)μmol·L-1),((102.29±29.38)ng·L-1 vs(139.86±28.84)ng·L-1)and((861.83±128.91)pg·mL-1 vs(971.69±156.22)pg·mL-1)(t=2.564,6.256,3.719,all P＜0.05).Furthermore,the cardiac function indicators of LEVSD,LVEDD and LVEF in both groups were significantly improved after treatment(all P＜0.05).The levels of LEVSD and LVEDD were significantly lower in the observation group than in the control((54.83±3.12)mm vs(57.42±3.26)mm)and((43.92±2.13)mm vs(45.76±2.16)mm)(t=4.393,P＜0.05).Additionally,LVEF was significantly higher in the observation group than in the control((50.26±3.41)%vs(47.21±3.32)%)(t=3.935,4.158,both P＜0.05).There was no statistically significant differ-ence in the incidence of adverse reactions between the two groups(χ2=0.382,P＞0.05).Conclusion SVST combined with metopr-olol can effectively reduce the degree of myocardial damage and improve cardiac function in elderly patients with hypertension and CHF.Meanwhile,it has definite efficacy and good safety.
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