高血压的固定剂量联合治疗:以氨氯地平和缬沙坦(Exforge®)固定剂量联合治疗为重点

S. Aslam
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引用次数: 2

摘要

高血压是世界范围内致残和心血管疾病死亡的主要原因。大约三分之一的美国成年人和全球超过10亿人患有高血压。尽管人们对高血压的认识不断提高,许多有效的降压药也越来越多,但只有三分之一的患者达到了目标血压(BP)。所有专家小组现在都建议对2期和高血压以及心血管疾病(CVD)风险增加的个体使用联合治疗。氨氯地平是一种二氢吡啶类钙通道阻滞剂,缬沙坦是一种血管紧张素II受体(AT1-R)拮抗剂,是广泛使用的降压药。它们在降低收缩压和舒张压以及减少心血管疾病事件方面的功效已在几项随机试验中得到证实。在副作用相似的随机试验中,固定剂量氨氯地平和缬沙坦(A/V)联合使用在降低血压方面比单独使用这两种药物中的任何一种更有效。大约80%-90%接受A/V固定剂量联合治疗的1-2期高血压患者获得显著缓解,定义为平均坐位舒张压较基线降低10mmhg。亚组分析显示,A/V固定剂量联合治疗对老年人(>65岁)、黑人、孤立性收缩期高血压患者和单药治疗失败的患者同样有效。此外,与单药治疗相比,A/V固定剂量联合治疗耐受性良好,简化了降压方案,增强了患者的依从性,更好地控制了血压。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fixed-dose Combination Therapy in Hypertension: Focus on Fixed-dose Combination of Amlodipine and Valsartan (Exforge ® )
Hypertension is the leading cause of disability and cardiovascular mortality world-wide. Approximately one-third of the US adult population and over a billion people world-wide have hypertension. Despite increased awareness of hypertension and availability of many effective antihypertensive agents, only one third of patients achieve their target blood pressure (BP). All expert panels now recommend use of combination therapy for stage 2 and higher hypertension and for individuals who are at increased risk of cardiovascular disease (CVD). Amlodipine, a dihydropyridine calcium channel blocker and Valsartan, an angiotensin II receptor (AT1-R) antagonist are widely used antihypertensive agents. Their efficacy in lowering systolic and diastolic BP and reducing CVD events has been demonstrated in several randomized trials. Fixed-dose combination of amlodipine and valsartan (A/V) has been shown to be more effective in lowering BP than monotherapy with either of these agents alone in randomized trials with comparable side effect profile. Approximately 80%–90% of patients with stage 1–2 hypertension receiving A/V fixed-dose combination achieve significant response, defined as a mean sitting diastolic BP 10 mmHg reduction from the baseline. Subgroup analyses show that A/V fixed-dose combination is equally effective in older individuals (>65), Blacks, in patients with isolated systolic hypertension, and in those who fail monotherapy. Furthermore, A/V fixed-dose combination is well tolerated and simplifies antihypertensive regimen enhancing patient adherence and a better BP control compared to monotherapy.
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