Effect of perindopril amlodipine combined with indapamide on treating primary hypertension:efficacy,antioxidant and autophagy mechanisms

Li Mingchun; Cao Qun'an; Zeng Yimei

doi:10.3969/j.issn.1672-8157.2025.03.007

Abstract：Objective To explore the effect of perindopril amlodipine tablets combined with indapamide on treatment of patients with primary hypertension(PH)and observe the impact on silent information regulator 1,autophagy-related protein 9a and quinone oxidoreductase 1.Methods A total of 108 patients with PH who were admitted to the Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2023 to June 2024 were recruited as the research subjects and di-vided into the control group and the combined group,with 54 cases in each group.The control group was treated with perindopril amlodipine tablets,and the combined group was treated with indapamide on the basis of the control group.The two groups were treated for 14 days.The blood pressure load and vascular function,cardiac strain parameters,autophagy and oxidation regulato-ry molecules and the incidence of adverse reactions were observed and compared between the two groups.Results The 24 h diastolic blood pressure,24 h systolic blood pressure and 24 h pulse pressure of the combined group were respectively(86.21±3.72)mm Hg(1 mm Hg≈0.133 kPa),(124.75±8.43)mm Hg and(50.04±6.92)mm Hg after the treatment,lower than(90.68±5.94)mm Hg,(137.75±10.26)mm Hg and(54.46±6.38)mm Hg of the control group.The blood pressure ratio of lower limbs and upper arms of the combined group was(1.76±0.24),higher than(1.49±0.23)of the control group,and there was significant difference(t=4.687,7.194,3.451,5.969,all P<0.05).The global circumferential strain,global longitudinal strain and left ven-tricular longitudinal strain of the combined group were respectively(-31.95±5.69)%,(-20.13±5.27)%and(-14.42±1.67)%after the treatment,higher than(-29.72±4.87)%,(-16.41±4.88)%and(-12.84±1.98)%of the control group,and there were sig-nificant differences(t=2.188,3.806,4.482,all P<0.05).The serum silent information regulator 1,autophagy-related protein 9a and quinone oxidoreductase 1 of the combined group were respectively(13.29±1.66)ng·L-1,(1.49±0.19)ng·mL-1 and(65.19±6.82)U·L-1 after the treatment,higher than(11.23±1.53)ng·L-1,(1.32±0.17)ng·mL-1 and(56.27±5.74)U·L-1 of the control group,and there were significant differences(t=6.706,4.900,7.353,all P<0.05).There was no significant difference in the total incidence of essential hypertension between the combined group(18.52%,10/54)and the control group(12.96%,7/54)(χ2=0.628,P=0.428).Conclusion The combination of perindopril amlodipine tablets and indapamide is effective in the treatment of PH.It can control blood pressure through multiple mechanisms and reduce myocardial injury,with the safety good.