ObjectiveTo investigate the relationship of 24-hour ambulatory pulse pressure (24hPP) with left ventricular mass index (LVMI) in elderly essential hypertension patients. MethodsThe data of 110 elderly patients with essential hypertension from January to December 2012 were collected in the study. All patients received 24-hour ambulatory blood pressure monitoring and echoeardiographic examination 24hPP and LVMI were calculated according to the results of 24-hour ambulatory blood pressure monitoring and echocardiographic measurements. The patients were divided into group A [24hPP<60 mm Hg (1 mm Hg=0.133 kPa), n=70] and group B (24hPP≥60 mm Hg, n=40). ResultsThe 24-hour systolic blood pressure and 24hPP for patients in group B were significantly higher than those in group A (P<0.001). Compared with group A patients, the interventricular septal thickness, left ventricular posterior wall thickness, left ventricular mass and left ventricular mass index were significantly higher in group B (P<0.05). Pearson correlation analysis showed that 24hPP had a positive correlation with LVMI in the elderly essential hypertension patients (r=0.33, P<0.001). Multiple stepwise regression analysis showed that 24hPP was the main factor for the increase of LVMI in elderly essential hypertension patients (β=0.90, P<0.001). ConclusionThe 24hPP is positively correlated with LVMI in elderly essential hypertension patients. The 24hPP is an important risk factor for left ventricular structural damage in elderly essential hypertensive patients.
摘要:目的: 比较咪达普利与培哚普利对原发性高血压患者的的降压效果和不良反应。 方法 :将入选的60例1～2级高血压病患者,随机分为2组,咪达普利组,每日晨起口服咪达普利(5～10 mg,1次/d),培哚普利组,每日晨起口服培哚普利(4～8 mg,1次/d)。治疗4周,观察2组治疗前、后的血压,记录不良反应。 结果 :经治疗后咪达普利与培哚普利组血压均明显下降(Plt;0.05),组间差异无统计学意义(P＞0.05);总不良反应发生率咪达普利组16.8%,培哚普利组20%,而咪达普利组的咳嗽发生率为6.8%,培哚普利组为16.8%。 结论 :咪达普利和培哚普利均能有效降压,二者降压效果相似,但咪达普利的咳嗽发生率较低。Abstract: Objective: To compare the antihypertensive efficacy and safety of imidapril versus peridopril in patients with essential hypertension. Methods : Selected 60 patients with mild to moderate essential hypertension, in which divided two groups by random.They were administered imidapril 5～10 mg once daily or and peridopril 4～8 mg once daily for 4 weeks. During the curative period of 4 weeks, the antihypertensive efficacy and adverse reaction were observed. Results :The blood pressure drecreased prominently in both groups after four weeks treament(Plt;0.05), but there was no significant difference in antihypertensive efficacy between the two groups(P＞0.05). The occurrence of the total adverse reaction in imidapril and peridopril groups was 16.8% and 20%, respectively, while the occurrence of the cough in two groups was 6.8% and 16.8%, respectively. Conclusion :Both imidapril and peridopril exert favourable and similar hepotensive effect, however the cough occurrence of imidapril is lower than that of peridopril.
Objective To assess the efficacy and safety of levoamlodipine besylate for essential hypertension. Methods We searched MEDLINE (1999 to October 2007), EMBASE (1999 to October 2007), The Cochrane Library (Issue 3, 2007), CNKI (1999 to 2007), Wanfang (1999 to 2007), VIP (1999 to 2007) and CBM (1999 to October 2007). The quality of included studies was critically evaluated. Data analyses were performed with The Cochrane Collaboration’ s RevMan 4.2 software. Results A total of 345 articles were retrieved, but only 17 were finally included. Meta-analyses showed that the effective rate in patients receiving levoamlodipine besylate was significantly higher than that in patients receiving indapamide (RD 0.14, 95%CI 0.06 to 0.22, P=0.0004), while no significant differences were noted between the levoamlodipine besylate group and other control groups. The incidence of adverse effects was significantly lower in the levoamlodipine besylate group compared to the indapamide group (RD –0.12, 95%CI –0.21 to –0.03, P=0.01), the amlodipine group (RD –0.06, 95%CI –0.11 to –0.01, P=0.02) and the nitrendipine group (RD –0.27, 95%CI –0.46 to – 0.08, P=0.006). No significant differences were observed between the levoamlodipine besylate group and other control groups. Conclusion Levoamlodipine besylate tends to have better efficacy and safety profiles compared with other antihypertensive drugs. However, most trials included in the review were of poor quality and, so, multi-center large-scale randomized controlled trials of higher quality are needed to confirm this.
Objective To observe the effect of combination of antihypertensive and lipid lowering therapy on arterial stiffness in elderly patients with mild to moderate essential hypertension. Methods A total of 216 elderly patients with mild to moderate essential hypertension were enrolled and treated by hydrochlorothiazide as the basic therapy for two weeks. Then the patients were randomly divided into four groups. Namely, the intensified antihypertensive and lipid lowering therapy group (hydrochlorothiazide 25 mg/d, Candesartan 8 mg/d, Rosuvastatin 10 mg/d, n=54), the intensified antihypertensive treatment group (hydrochlorothiazide 25 mg/d, Candesartan 8 mg/d, n=54), the antihypertensive and lipid lowering therapy group (hydrochlorothiazide 25 mg/d, Rosuvastatin 10 mg/d, n=54), and the control group (hydrochlorothiazide 25 mg/d, n=54). After 12-month treatment, the blood pressure, blood lipid and carotid-radial pulse wave velocity (crPWV) of each group were recorded. Results Twelve months later, the SBP, DBP, PP and crPWV of each group were significantly lower than before (Plt;0.05). There was interactive effect of antihypertensive and lipid lowering therapy in lowering SBP, DBP, PP and crPWV (F=40.765, 4.869, 24.829, and 53.149, respectively, all Рlt;0.05). Conclusion The combination of antihypertensive and lipid lowering therapy can significantly lower the crPWV of elderly patients with hypertension and improve the arterial stiffness; it is superior to single treatment of either antihypertensive or lipid lowering.
Objective To investigate influence factors of childhood essential hypertension and provide scientific evidence for prevention and management of the disease. Methods Relevant studies were searched using PubMed, ISI Web of Knowledge, Ovid, CNKI and VIP from January 2007 to December 2011. STATA 11 was applied for meta-analysis. After heterogeneity analysis, influence factors (OR with 95%CI) were estimated using fixed or random effect models. Sensitivity analyses were used for evaluating the robustness of the results. Publication bias was assessed by Egger’s test and funnel plot. Results A total of 13 studies involving 4 278 cases and 37 230 controls were included. The pooled OR and its 95%CI of different factors associated with hypertension among children were: gender (male) 1.283 (1.063 to 1.549), age 1.013 (0.975 to 1.052), overweight 2.622 (1.985 to 3.464), obesity 3.730 (2.299 to 6.051), waist circumstance 1.060 (1.036 to 1.085), family history 1.189 (0.956 to 1.480), and frequency of physical activities 0.584 (0.460 to 0.742). Conclusion Current results indicate that gender (male), overweight, obesity, waist circumstance are risk factors of hypertension among children, while frequency of physical activities is protective factor.
ObjectiveTo assess the causal relationship between cervical vertebra related disorders and essential hypertension using a bidirectional two-sample Mendelian randomization study approach. MethodsThe research data comes from the genome-wide association study dataset. Four types of cervical vertebra related disorders: cervicalgia, cervical disc disorders, cervical root disorders, injury of nerves and spinal cord at neck level, as well as data on essential hypertension, were selected for the study. Relevant single nucleotide polymorphisms were selected as instrumental variables to assess the causal relationship between cervical vertebra related disorders and essential hypertension mainly by inverse variance weighted model ratio. Cochran's Q test was used to detect heterogeneity, MR-Egger intercept term and MR-PRESSO was used to detect multiplicity, and leave-one-out method was used for sensitivity analysis. ResultsCervicalgia had a positive causal relationship with the essential hypertension (OR=1.01, 95%CI 1.00 to1.02, P=0.019). Essential hypertension had a positive causal relationship with the cervical disc disorders (OR=4.08, 95%CI 1.57 to10.61, P=0.004). There was no significant causal relationship between cervical root disorders, injury of nerves and spinal cord at neck level and essential hypertension. Reliability assessment indicates that the study results were reliable. ConclusionCervicalgia is a risk factor for essential hypertension; Essential hypertension is a risk factor for cervical disc lesions; There is no correlation between cervical root disorders, injury of nerves and spinal cord at neck level and essential hypertension.
ObjectivesTo evaluate the methodological quality and the reliability of the conclusions of systematic reviews (SRs) on traditional Chinese medicine (TCM) treatment for essential hypertension. MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were searched to collect the SRs which focused on the TCM for essential hypertension from January 2015 to June 2019. PRISMA statement, AMSTAR 2 tool and GRADE system were respectively applied to evaluate report quality, methodological quality and evidence quality assessment of included outcomes of SRs.ResultsA total of 25 SRs involving 65 outcomes were included. PRISMA evaluation results showed that the quality of 25 SRs reports was good. However, all studies did not report item 5 " Was an ‘a prior’ design provided?”. AMSTAR 2 tool evaluation results showed that the 25 SRs of quality levels were markedly low, where most problems concerned item 2 " If there is ‘a prior’ published in advance”, item 3 " Were reasons about selection of the study designs explained”, item 7 " Were the list of exclude of studies and justify the exclusions provided”, item 10 " Were the sources of funding for the studies reported”, and item 12 " If meta-analysis was performed, whether the author assesses the potential impact of risk of bias”. The results of grading showed that most outcomes were graded as " low” or " very low” quality. The main factors contributing to downgrading evidence quality were limitations, followed by inconsistencies, inaccuracies and publication bias.ConclusionsCurrent evidences shows that the treatment of essential hypertension by TCM has been supported by low quality evidence-based medical evidence. However, the SRs methodology for the treatment of essential hypertension by TCM is generally poor in quality and the standardization still require improvement.
Objective To evaluate the efficacy and safety of Niuhuangjiangya tablets (NT) on mild to moderate primary hypertension (overabundant liver-fire) in comparison with Niuhuangjiangya pills (NP). Method The double-dummy and randomized controlled method was adapted to assess 240 patients (overabundant liver-fire) who were divided into the treatment group (n =120, treated with NT 2 tablets, twice a day) and the control group (n =120, treated with NP 1 pill, twice a day).The duration of treatment for both groups was 4 weeks. Results Blood pressure began to decline in the first week of treatment. After 4 weeks, the mean diastolic and systolic blood pressure dropped 7.51 and 12.16 mmHg, respectively, in the treatment group; 7.53 and 12.45 mmHg dropped respectively in the control group. For diastolic blood pressure, the total efficacy rates of the two groups were 50.8% and 54.9% (Pgt;0.05), respectively. For TCM syndromes, the total efficacy rates of the two groups were 45.6% and 42.34% (Pgt;0.05), respectively. The two drugs were equivalent by the equivalent test (Plt;0.05). No adverse effect was found in the study. Conclusions Niuhuangjiangya tablets have confirmed that the effects on mild to moderate hypertension has few side effects. The efficacy of the two drugs is equivalent by the equivalence test. placebo=controlled trials are required.