Clinical efficacy and safety of the combination of carvedilol and EECP in the treatment of patients with essential hypertension combined with accelerated resting heart rate

Xie Danqi; Chen Ruirui; Yan Huan; Wen Fangfang

doi:10.3969/j.issn.1674-3245.2025.04.004

Abstract：Objective To observe the clinical efficacy and safety of the combination of carvedilol and enhanced external counterpulsation(EECP)in the treatment of patients with essential hypertension combined with accelerated resting heart rate.Methods Prospectively,140 patients with essential hypertension combined with accelerated resting heart rate admitted from June 2022 to June 2024 were divided into two groups.The carvedilol group was given carvedilol treatment,and the EECP group was treated with carvedilol combined with EECP.Changes in dynamic heart rate,dynamic blood pressure and vascular sclerosis-related indexes[brachial ankle pulse wave conduction velocity(baPWV)]were detected before and after treatment in the two groups,the Duchenne hypertension quality of life scale scores were assessed before and after treatment in the two groups,and adverse reactions were recorded in the two groups.Results Ambulatory heart rate and ambulatory blood pressure-related indices were lower in both groups after treatment compared with before treatment,and the EECP group had lower ambulatory heart rate and ambulatory blood pressure indexes than the carvedilol group after treatment(t=5.528,8.009,7.132,4.270,3.387,4.124,5.416,5.055,8.211,6.239,3.898,P＜0.05).The baPWV[carvedilol group(1477.56±216.56)cm/s vs.observation group(1382.25±178.89)cm/s]was lower in both groups after treatment compared with that before treatment(t=3.648,7.806,P＜0.05);however,the baPWV was lower than that of carvedilol group in EECP group after treatment(t=2.839,P＜0.05).The scores of physiological condition,somatic symptoms,sexual dysfunction,sleep condition,anxiety,depression,anger or vitality,hostility,obsessive-compulsive symptoms,interpersonal sensitivity,and work status were elevated in both groups after treatment compared with before treatment,and the Duchenne hypertension quality of life scale scores,except for anger or vitality,were higher in the EECP group after treatment were higher than those of the carvedilol group(t=21.426,10.744,11.195,4.422,13.095,11.932,15.229,13.768,6.766,7.950,P＜0.05).The total effective rate in the EECP group[92.86％(65/70)]was higher than that in the carvedilol group[80.00％(56/70),which was different(x2=4.933,P=0.026).The cumulative incidence of adverse effects in the EECP group[14.29％(10/70)]was comparable to that of the carvedilol group[12.86％(9/70)]compared with the carvedilol group[12.86％(10/70)],and there was no difference(x2=0.061,P=0.805).Conclusion The combination of carvedilol and EECP in the treatment of essential hypertension combined with accelerated resting heart rate improves blood pressure and heart rate,reduces baPWV and IMT levels,and improves quality of life.