Effects of bisoprolol combined with levamlodipine on renin-angiotensin-aldosterone system and carotid artery elasticity in patients with hypertension / 中国医师进修杂志

ABSTRACT

Objective:To analyze the effects of bisoprolol combined with levamlodipine on renin-angiotensin-aldosterone system (RAAS) and carotid artery elasticity in patients with hypertension.Methods:The 90 hypertensive patients who treated in the Wangjiangjing Hospital of Jiaxing Xiuzhou District from January 2021 to August 2021 were enrolled in this study, and they were divided into the control group and the combination group according to the treatment methods, each with 45 cases. The control group was treated with levoamlodipine, and the combination group was treated with bisoolol plus levoamlodipine. Three months of treatment was a course, and both groups were treated for 5 consecutive courses. The clinical efficacy, ventricular remodeling indicators, RAAS related hormone levels, carotid artery vascular elasticity function, and adverse reactions were compared between the two groups.Results:The total effective rate in the combination group was higher than that in the control group: 95.56%(43/45) vs. 82.22%(37/45), there was statistical difference ( χ2 = 4.05, P<0.05). After treatment, the interventricular septal thickness, left ventricular end-diastolic diameter, left ventricular posterior wall thickness and left ventricular mass index in combination group were lower than those in control group: (8.52 ± 1.84) mm vs. (9.41 ± 2.09) mm, (48.53 ± 1.94) mm vs. (50.47 ± 2.35) mm, (9.12 ± 2.10) mm vs. (11.06 ± 2.38) mm, (88.96 ± 12.72) g/m 2 vs. (96.56 ± 13.39) g/m 2, there were statistical differences ( P<0.05). After treatment, the serum levels of angiotensin Ⅱ, renin, angiotensin converting enzyme and aldosterone in combination group were lower than those in control group: (44.47 ± 4.27) ng/L vs. (48.63 ± 5.34) ng/L, (0.34 ± 0.07) μg/(L·h) vs. (0.41 ± 0.08) μg/(L·h), (9.09 ± 0.66) U/L vs. (9.45 ± 0.75) U/L, (123.43 ± 14.08) ng/L vs. (131.36 ± 15.7) ng/L, there were statistical differences ( P<0.05). There were no significant differences in left and right carotid intima media thickness and carotid resistance index before and after treatment between the two groups ( P>0.05). After treatment, the pulse wave conduction velocity at the beginning of left and right common carotid artery contraction(PWV-BS) and the pulse wave conduction velocity at the end of contraction (PWV-ES) were decreased in both groups, and the left and right PWV-BS and PWV-ES in the combination group were lower than those in the control group: (5.42 ± 0.64) m/s vs. (6.02 ± 0.8) m/s, (4.89 ± 0.67) m/s vs. (5.86 ± 0.98) m/s, (8.02 ± 0.86) m/s vs. (9.34 ± 1.24) m/s, (6.98 ± 0.67) m/s vs. (8.02 ± 0.87) m/s, there were statistical differences ( P<0.05). Conclusions:Bisoprolol combined with levamlodipine can effectively improve the blood pressure control effect of hypertensive patients, improve the levels of RAAS related hormones, reverse ventricular remodeling, and improve carotid artery vascular elasticity function, without increasing the risk of adverse reactions.