Clinical research of drug intervention in hypertension secondary to left ventricular diastolic dysfunction
Abstract：Objective To evaluate the clinical curative effect and safety of angiotensin Ⅱ receptor antagonist(ARB),β1 receptor blockers combined with aldosterone antagonists (three drug regimen) and ARB,β1 receptor blockers(two drug regimen) in the treatment of patients with hypertension secondary to left ventricular diastolic dysfunction.Methods Totally 249 cases of hypertension secondary to left ventricular diastolic dysfunction were recruited from October 2010 to April 2012 and were divided into the observation group(121 cases) and control group(128 cases).Patients in the control group were given ARB + β1 receptor blockers (two drug regimen) and patients in the observation group were given ARB + β1 receptor blockers + aldosterone antagonists(three drug regimen).All of the patients were treated and followed up for 24-month.Changes of 2 groups of blood pressure,left ventricular function,brain natriuretic peptide(BNP) were analyzed.Results The serum BNP of 2 groups after treatment was lower than that before treatment [the observation group:(128 ± 25)ng/L vs (204 ± 34)ng/L,the control group:(156 ± 27) ng/L vs (200 ± 33) ng/L,P ＜ 0.05],but serum BNP was much lower in the observation group than that in control group after treatment(P ＜ 0.05).The blood pressure of 2 groups after treatment was lower than that before treatment; left ventricular ejection fraction and mitral early diastolic velocity/late diastole blood flow velocity were higher than those before treatment [systolic pressure:(139 ± 16) mmHg (1 mmHg =0.133 kPa)vs (163±25)mmHg,(137±17)mmHgvs (162±25)mmHg; diastolic pressure:(89±14)mmHg vs (98 ± 19) mmHg,(89 ± 13) mmHg vs (98 ± 20) mmHg ; left ventricular ejection fraction:(58 ± 5) ％ vs (53 ± 4) ％,(52 ± 5) ％ vs (46 ± 5) ％ ; mitral early diastolic velocity/late diastole blood flow velocity:(1.34 ± 0.68) vs (0.68 ± 0.23),(1.06 ± 0.55) vs (0.71 ± 0.21),all P ＜ 0.05].The blood pressure was significantly decreased; left ventricular ejection fraction and mitral early diastolic velocity/late diastole blood flow velocity were significantly improved in both groups(P ＜ 0.05).Twenty-one and forty-four cases of heart failure were observed in the observation and control group and demonstrated the higher risk in control group(hazard ratio =0.41,95％ confidence interval:0.25-0.66,P ＜ 0.01).Conclusion These drug regimes have the clinical efficacy in the treatment of hypertension secondary to left ventricular diastolic dysfunction,but the three drug regiment can significantly decrease the risk of developing heart failure.
Keywords：Heart failure,diastolicHypertensionNatriuretic peptide,brain
Publication Date：2014-08-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1093-1097 )