Efficacy and safety of fixed combination of nitrendipine and atenolol in treatment for patients with mild to moderate essential hypertension and their optimal dosage matching / 中华全科医师杂志

Objective To evaluate efficacy and safety of fixed combination of nitrendipine and atenolol in treatment for patients with mild to moderate essential hypertension and their optimal dosage matching.Methods Totally,275 patients with essential hypertension were selcted from seven hospitals in Shanghai,Nanjing and Suzhou,China and randomized into five groups with same proportional probability in a double-blind,double-dummy,parallel active-controlled,multi-center clinical trial,receiving fixed combination of nitrendipine and atenolol at three different dosage matching (nitrendipine/atenolol 5/12.5 mg,5/10 mg,5/7.5 mg for groups 1,2 and 3),and nitrendipine (10 mg for group 4) or atenolol (25 mg for group 5),respectively for eight weeks.Results Mean reduction of diastolic blood pressure (DBP)was (17±7) mm Hg,(18±9) mm Hg and (17±7) mm Hg for groupl,2 and 3,respectively from the baseline,significantly greater than that in groups 4 and 5[(13±7) mm Hg and (12±6) mm Hg,respectively].Mean reduction of systolic blood pressure (SBP) was (21 ±11)mm Hg,(24±12) mm Hg,(23±11) mm Hg,(19±13) mm Hg and (18±9) mm Hg,respectively for the five groups from the baseline,and the reduction in group 2 was significantly greater than that in group 5,with an overall efficacy of 94.4%,98.1% and 88.2% for groups 1,2 and 3,respectively,all statistically higher than that in group 5 (71.4%) with P＜0.01,eight weeks after treatment.The ratio of patients with increased dose of antihypertensive agents in week 5 was lower in group 2 than that in the other four groups,with mild adverse reaction only,no obvious change in laboratory biochemical examinations,and no needs in special management.Conclusions Fixed combination of atenolol and nitrendipine with an optimal doses of 5 mg and 10 mg respepctively was effective and safe for mild and moderate hypertension with good tolerance.

Neuregulin-1 therapy improved cardiac function and reduced ANPmRNA expression in post myocardial infarction rats with cardiac dysfunction / 老年心脏病学杂志（英文版）

To observe the influence of neuregulin-1 on the cardiac function of post-myocardial infarction rats. Methods Left ventricular MI was created in Sprague-Dawley rats by ligation of the left anterior descending coronary. Six months after the operation, rats were evaluated with echocardiology methods. 36 rats that had an infarct area and a EF around 60% were randomized into 3 groups: MI group(n=12) were injected a blank vehicle fluid intravenously for 5 days, after which they continued to be raised on standard food and water for 30 days. MI+NRG group(n=12), received NRG-110μg·kg-1 intravenously for 5 days, after which they continued to be raised on standard food and water for 30 days. MI+Capt group (n=12) received captopril orally (dissolved in their drinking water 2g/L) for 30days, after which tap water substituted the solution for 5 days. Final echocardiographic and hemodynamic measurements were made at the end of 1 month of therapy. Total RNA was extracted from frozen left ventricular tissues, and was reverse transcribed into firststrand PCR was performed with primers for BNP、 ANP. Results Rats treated with neuregulin had a smaller LVDs (P=0.014), a betterLVEF (P=0.004),and a tendency towards less lung perfusion than untreated rats. Neuregulin decreased the expression of ANP mRNA in the ventricle (P=0.025).Conclusion Neuregulin markedly improved the cardiac function of rats that survived myocardial infarction,and decreased the expression of ANP mRNA in the ventricle.

Effect of telmisartan on plasma levels of inflammatory cytokine in unstable angina patients complicated with diabetes mellitus and hypertensive after percutaneous coronary intervention / 中国康复理论与实践

@# ObjectiveTo observe the effect of telmisartan on plasma levels of inflammatory cytokine in coronary artery disease (CAD) patients complicated with diabetes mellitus and hypertension after percutaneous coronary intervention.MethodsFifty CAD patients who just had undertook angioplasty and implanted stents were randomly divided into two groups, the test group (telmisartan group, n=25) and control group (perindopril group, n=25). After treatment, patients were followed-up for 6 months; plasma samples were collected from each patient before and after percutaneous coronary intervention. Then plasma levels of C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1) were measured by enzyme-linked immunoassay. The changes of cholesterol, fasting plasma glucose (FPG), insulin and insulin resistance index (IRI) were observed.ResultsAt the end of 6 months, plasma levels of CRP and MCP-1 of patients in the test group significantly declined (P<0.01), and showing a inversely correlation with FPG (P<0.01), and FPG, insulin and IRI also declined. In the control group, only CRP and MCP-1 declined (P<0.05). Meanwhile, the frequency of cardiovascular events in test group was significantly lower than that in the control group.ConclusionTelmisartan can decline plasma levels of CRP, MCP-1 and frequency of cardiovascular events as well as increasing insulin sensitivity and improving glucose metabolism to unstable angina patients.

Changes of Cardiac Function in CHF rats after Blocking the Renin Angiotensin-Aldosterone System at Different Sites / 复旦学报（医学版）

PurposeTo observe the effects of blocking the renin-Angiotensin-Aldosterone system at different sites in experimental congestive heart failure (CHF)rats. Methods Six weeks after coronary ligation, rats( n = 66)were randomized to benalapril, losartan, spironolactone, placebo, and treated for 6 weeks. Sham-operated rats( n = 18) served as controls. Six weeks later left ventricular hemodynamics were measured. Results In the hemodynamic variables, HR was not significantly different between groups. Compared four treatment groups with sham-operated group, LVEDP increased, LVPSP and ± dp/dtmax decreased (P＜0.05). Compared with placebo group,all data in spironolactone group were not significantly different, LVEDP, mortality in benalapril group and in losartan group decreased, LVPSP and ± dp/dtmax in benalapril group and in losartan group increased(P ＜ 0.05). ConclusionsAdministration of ACEI and Ag Ⅱ-AT1 antagonist are effective in preventing from cardiac function deterioration, while spironolactone treatments are not. Spironolactone has tendency in decreasing LVEDP.

Comparison of Cilazapril or Enalapril in Treatment of Patients with Essential Hypertension / 中华高血压杂志

Objective To study efficacy and safety of cilazapril in treating patients with essential hypertension.Method 115 patients with hypertension were divided randomly into two groups:59 were treated with cilazapril and 56 were treated with enalopril.All the patients were washed out for one week,then took 2.5 mg cilazapril or 10 mg enalapril once a day in each group respectively for 8 weeks.If blood pressure was not reduced 2 weeks later,hydrochlorothiazide was added. Result The effective rate of cilazapril and enalapril was 89.8% and 91.1% respectively.The SBP and DBP reduced from 153±15 mmHg and 104±9 mmHg to 131±11 mmHg and 91±8 mmHg respectively in cilazapril group,and from 155±12 mmHg and 102±10 mmHg to 139±14 mmHg and 90±9 mmHg respectively in enalapril group.There were no significant differences in two groups. No side effects were observed in two groups. Conclusion Cilazapril is an effective and safe agent in treatment of mild and moderate essential hypertesion.

Transcatheter Electrical Ablation for Treatment of Patients With Refractory Ventricular Tachycardia and Its Long-term Efficacy / 中国介入心脏病学杂志

Transcatheter electrical ablation was performed in 5 patients, none of them showed clinical effectiveness for treatment of antiarrhythmic drugs, with recurrent sustained ventricular tachycardia (VT). The localization of ventricular ectopic focus mainly depended upon the results of pace mapping. Energy used for each transcatheter electrical ablation (TEA) was usually 150-250J and the total energy was 550J to 800J respectively for each patient. No recurrence of VT was ob-served in 4 cases during 19 to 41 (mean 26. 8) months of follow-up period, two of them without adminstration of drug. Sustained VT relapsed during the 4th months after ablation in one case, however, heart rate during VT was much slower than before. Our experience suggests that long-term effectiveness of TEA for treatment of drug-resist VT is inspiring.