Therapeutic effect of ramipril and nifedipine on aged patients with hypertensive heart disease and its influence on cardiac function and inflammatory factor level ／ / 心血管康复医学杂志

ABSTRACT

Objective:To explore therapeutic effect of ramipril tablet and nifedipine controlled release tablet on aged patients with hypertensive heart disease and its influence on cardiac function and inflammatory factor level .Methods:A total of 186 aged patients with hypertensive heart disease were randomly equally divided into ramipril group ,nifedipine group and com‐bined treatment group (received ramipril + nifedipine).After eight weeks ,the therapeutic effect were observed and com‐pared among all groups.Results:Compared with before treatment , there were significant rise in LVEF ,cardiac index (CI) ,left ventricular early diastolic／late diastolic peak flow velocity (E／A) and 6min walking distance (6MWD) ,and sig‐nificant reductions in plasma levels of BNP ,CRP ,interleukin (IL)‐1 and IL‐6 after treatment in three groups , P＜0.01 all.Compared with ramipril group and nifedipine group after treatment ,there were significant rise in LVEF [ (43.44 ± 5.75)%,(43.41 ± 5.73)% vs.(49.89 ± 5.84)%] ,CI [(2.23 ± 0.64) L·min－1 ·m－2 ,(2.28 ± 0.69) L·min－1 ·m－2 vs.(2.87 ± 0.71) L·min－1 ·m－2 ] ,E／A [(0.87 ± 0.31) ,(0.90 ± 0.32) vs.(1.21 ± 0.39)] ,6MWD [(233.44 ± 38.95) m ,(236.45 ± 39.13) m vs.(299.77 ± 45.77) m] ,and significant reductions in plasma levels of BNP [ (199.67 ± 27.86) ng／L ,(194.55 ± 25.46) ng／L vs.(124.67 ± 29.45) ng／L] ,CRP [ (10.32 ± 3.18) mg／L ,(10.21 ± 2.89) mg／L vs. (8.35 ± 2.12) mg／L] , tumor necrosis factor (TNF)‐α [ (45.52 ± 14.56) pg／ml ,(45.45 ± 13.78) pg／ml vs.(37.86 ± 10.35) pg／ml] ,IL‐1 [ (6.34 ± 2.54) pg／ml ,(6.31 ± 2.31) pg／ml vs.(3.42 ± 1.89) pg／ml] and IL‐6 [ (6.71 ± 2.23) pg／ml ,(6.68 ± 2.11) pg／ml vs.(4.11 ± 1.75) pg／ml] , P＝0.001 all.Over all therapeutic effect of combined treatment was significantly higher than that of ramipril group ( Z＝ 3.747 , P＝ 0.001 ) and nifedipine group ( Z＝ 3.838 , P＝0.001).Conclusion:Ramipril combined nifedipine can improve therapeutic effect and cardiac function ,and reduce plasma levels of inflammatory factors in aged patients with hypertensive heart disease .