Research of candesartan combined with levamlodipine besylate on target organ protection in patients with hypertension / 中国医师进修杂志

ABSTRACT

Objective To explore the effect of candesartan combined with levamlodipine besylate on hypertension and target organ protection.Methods One hundred and twenty-two patients with hypertension and proteinuria from February 2011 to July 2013 were divided into observation group (61 cases) and control group (61 cases) by random number table method.Patients in both groups were given oral candesartan 8 mg/d,and the observation group was treated with levamlodipine besylate 2.5 mg/d on this basis.Six months after treatment,the blood pressure levels,carotid intima-media thickness (IMT),interventricular septum thickness (IVST),left ventricular posterior wall thickness (LVPWT),left ventricular end diastolic diameter (LVEDD),left ventricular mass index (LVMI) and renal function between 2 groups were observed.Results After 6 months of treatment,the total effective rate in observation group was 86.9％ (53/61),and in control group was 72.1％ (44/61),there was significant difference (P ＜ 0.05).Systolic blood pressure and diastolic blood pressure levels in two groups after treatment were decreased,in observation group which were lower than those in control group,and there was significant difference (P ＜ 0.05).IVST,LVEDD,LVPWT,LVMI and carotid IMT in 2 groups after treatment was lower than that before treatment,in observation group which was obviously lower than that in control group [(8.5 ± 1.3) mm vs.(9.2 ± 1.2) mm,(39.6 ± 4.8)mm vs.(44.3 ± 3.9) mm,(8.4 ± 1.4) mm vs.(9.1 ± 1.3) mm,(89.4 ± 9.3) g/m2 vs.(97.3 ± 8.9) g/m2,(8.3 ± 0.3) mm vs.(8.7 ± 0.5) mm],and there were significant differences (P ＜ 0.05).Urea nitrogen between 2 groups before and after treatment had no significant difference(P ＞ 0.05).The serum creatinine,creatinine clearance rate,total 24 h urinary albumin and microalbuminuria in 2 groups was significandy improved compared with that before treatment,and in observation group after treatment was obviously improved compared with that in control group [(94.6 ±25.5) μmol/L vs.(118.5 ±38.4) μmol/L,(102 ±24) ml/min vs.(96 ± 18) ml/min,(1.05 ± 0.51) mg/24 h vs.(1.27 ± 0.22) mg/24 h,(155 ± 36) mg/L vs.(185 ± 41) mg/L],there were significant differences (P ＜ 0.05).Conclusions The effect of candesartan combined with levamlodipine besylate in treatment of hypertension and proteinuria is better than monotherapy.Combination therapy in reversing left ventricular,improving carotid IMT,protecting kidney function and reducing proteinuria has significant effect,and has no obvious adverse reactions.It is worthy of clinical application.