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1.
Chinese Journal of Cardiology ; (12): 510-513, 2008.
Article in Chinese | WPRIM | ID: wpr-243743

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the association between the anti-atherosclerotic effects of amlodipine and angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in elderly essential hypertensive (EH) patients.</p><p><b>METHODS</b>A total of 220 EH patients were treated with amlodipine (2.5 - 10 mg, once daily) for twelve months and complete data were obtained from 208 patients with genotypes of II (n = 90), ID (n = 91) and DD (n = 27). The indices of carotid arterial were compared before and post amlodipine treatment in patients with identical genotype and among different ACE genotypes and each genotype post therapy.</p><p><b>RESULTS</b>The carotid mean intimal-medial thickness (MIMT) was slightly decreased in EH patients with ID and DD genotypes and significantly decreased in EH patients with II genotype (0.96 +/- 0.12 vs. 0.92 +/- 0.13, P < 0.01) compared to pre-treatment values. The decreased degree of MIMT (DeltaMIMT) in II genotype was significantly higher in II genotype than those in ID or DD genotype (0.05 +/- 0.03 vs. 0.01 +/- 0.02, 0.01 +/- 0.03 respectively, P < 0.01). The post treatment plaque score (PS) in patients with II genotype was significantly reduced (4.85 +/- 2.51 vs. 3.90 +/- 2.36, P < 0.05). Multivariate linear regression analysis showed the baseline SBP, the decreased degree of SBP (DeltaSBP) and the II genotype were the major factors affecting the DeltaMIMT.</p><p><b>CONCLUSION</b>Hypertensive patients carrying II genotype ACE genotype are the best responders for the anti-atherosclerotic effects of amlodipine.</p>


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Amlodipine , Therapeutic Uses , Carotid Artery Diseases , Pathology , Gene Frequency , Genotype , Hypertension , Drug Therapy , Genetics , Pathology , Peptidyl-Dipeptidase A , Genetics , Polymorphism, Genetic , Treatment Outcome
2.
Journal of Central South University(Medical Sciences) ; (12): 719-725, 2005.
Article in Chinese | WPRIM | ID: wpr-813439

ABSTRACT

OBJECTIVE@#To determine the therapeutic status and rate of reaching target blood pressure in elderly isolated systolic hypertension (EISH) patients who were hospitalized and to discuss the rationality of the drug therapy.@*METHODS@#Three hundred and fifty-seven EISH inpatients were investigated retrospectively. The frequencies of using antihypertensive drugs and the strategy of drug therapy programs were calculated. The drug efficacies were assessed among various drug therapy groups.@*RESULTS@#The frequencies of using antihypertensive medicine categories were calcium channel blocker (CCB) 64. 15%, angiotensin-converting enzyme inhibitor (ACEI) 32.77%, diuretics 26.33%, beta-blocker (BB) 25.77%, angiotensin receptor blocker (ARB) 23.81%, and alpha-blocker 4.20%, respectively. Among the 357 cases 42.86% were treated with monotherapy while 57.14% with combined therapy. Among the combination therapy groups, the diuretic-based multiple therapy occupied 16.53%, and the non-diuretic-based multiple therapy held 40.62%. The systolic blood pressure control rate was 67.79%. The rate of diastolic blood pressure < or = 70 mmHg was 26.89%, 8 cases of them occurred myocardial ischemia.@*CONCLUSION@#How to select the optimal antihypertensive drug therapy for EISH patients is important in achieving the blood pressure goal. While thinking over intervention at lower blood pressure levels to achieve target goals, physicians should prevent from excessively lowering the diastolic blood pressure.


Subject(s)
Aged , Female , Humans , Male , Adrenergic beta-Antagonists , Therapeutic Uses , Angiotensin-Converting Enzyme Inhibitors , Therapeutic Uses , Antihypertensive Agents , Therapeutic Uses , Calcium Channel Blockers , Therapeutic Uses , Diuretics , Therapeutic Uses , Drug Therapy, Combination , Hypertension , Drug Therapy , Retrospective Studies , Systole
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