Aggressive antihypertensive therapy based on hydrochlorothiazide, candesartan or lisinopril as initial choice in hypertensive type II diabetic individuals: effects on albumin excretion, endothelial function and inflammation in a double-blind, randomized clinical trial
Aggressive antihypertensive therapy based on hydrochlorothiazide, candesartan or lisinopril as initial choice in hypertensive type II diabetic individuals: effects on albumin excretion, endothelial function and inflammation in a double-blind, randomized clinical trial
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基于氢氯噻嗪、坎地沙坦或赖诺普利的积极抗高血压治疗作为 II 型高血压糖尿病患者的首选：双盲随机临床试验对白蛋白排泄、内皮功能和炎症的影响
DOI：
10.1038/sj.jhh.1001812
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发表时间：
2005
影响因子：
2.7
通讯作者：
C. Stehouwer
中科院分区：
文献类型：
--
作者：
MT Schram;Fj van Ittersum;A. Man;Rajm van Dijk;CG Schalkwijk;RG IJzerman;Jwr Twisk;C. Stehouwer
我们研究了基于氢氯噻嗪、坎地沙坦或赖诺普利的积极抗高血压治疗对 II 型高血压糖尿病患者尿白蛋白排泄、内皮功能和炎症活动的影响。在随机、双盲、双模拟设计中，共有 70 名 II 型高血压糖尿病患者接受了三种抗高血压策略的治疗。血压滴定至低于 130/85mmHg 的水平，或收缩压降低 10%，舒张压低于 85mmHg。滴定后，患者接受12个月的治疗。氢氯噻嗪 (n=24)、坎地沙坦 (n=24) 和赖诺普利 (n=22) 组的平均血压从基线时的 157/93、151/94 和 149/93 变为滴定后的 135/80、135/82 和 131/80mmHg。大约 70% 的人达到了目标血压。然而，只有 45% 的人血压<130/85mmHg。尿白蛋白排泄量以及可溶性血管细胞粘附分子-1和细胞间粘附分子-1水平降低（GEE回归系数，-2.40mg/24h（P<0.001）、-85ng/ml（P=0.01）和-50ng/ml（P=0.02）），但肱动脉内皮依赖性和非依赖性血管舒张以及血管性血友病因子和C反应蛋白水平没有变化（GEE回归系数，0.21 mm（P=0.07）、0.04 mm（P=0.43）、0.04 IU/ml（P=0.33）和-1.15 mg/l（P=0.64））。没有观察到治疗组之间的结果变量存在差异。这些数据表明，高血压 II 型糖尿病患者很难实现低于 130/85mmHg 的目标血压。无论使用何种类型的抗高血压治疗，积极的抗高血压治疗都可以改善高血压 II 型糖尿病患者的尿白蛋白排泄、内皮功能和炎症活动。
We investigated the effects of aggressive antihypertensive therapy based on hydrochlorothiazide, candesartan or lisinopril on urinary albumin excretion, endothelial function and inflammatory activity in hypertensive type II diabetic individuals. A total of 70 hypertensive type II diabetic individuals were treated with three antihypertensive strategies in a randomized, double-blind, double-dummy design. Blood pressure was titrated to levels below 130/85 mmHg or a decrease in systolic pressure of 10% with a diastolic pressure below 85 mmHg. After titration, patients were treated for 12 months. Mean blood pressures changed from 157/93, 151/94 and 149/93 at baseline to 135/80, 135/82 and 131/80 mmHg after titration in the hydrochlorothiazide (n=24), candesartan (n=24) and lisinopril (n=22) groups. About 70% reached target blood pressures. However, only 45% had blood pressures <130/85 mmHg. Urinary albumin excretion and levels of soluble vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 decreased (GEE regression coefficients, −2.40 mg/24 h (P<0.001), −85 ng/ml (P=0.01) and −50 ng/ml (P=0.02)), but brachial artery endothelium-dependent and -independent vasodilation and levels of von Willebrand factor and C-reactive protein did not change (GEE regression coefficients, 0.21 mm (P=0.07), 0.04 mm (P=0.43), 0.04 IU/ml (P=0.33) and −1.15 mg/l (P=0.64)). No differences in outcome variables between treatment groups were observed. These data show that achievement of target blood pressures below 130/85 mmHg in hypertensive type II diabetes is difficult. Aggressive antihypertensive therapy can improve urinary albumin excretion, endothelial function and inflammatory activity in hypertensive type II diabetic individuals, regardless of the type of antihypertensive therapy used.
影响因子：
158.5
作者：
Estacio, RO;Jeffers, BW;Schrier, RW
通讯作者：
Schrier, RW
氯沙坦对衰老相关内皮损伤的影响。
DOI：
10.1016/s0002-9149(01)02297-4
发表时间：
2002
期刊：
The American journal of cardiology
影响因子：
--
作者：
Rajagopalan,Sanjay;Brook,Robert;Mehta,RajendraH;Supiano,Mark;Pitt,Bertram
通讯作者：
Pitt,Bertram
影响因子：
158.5
作者：
Ridker, PM;Hennekens, CH;Rifai, N
通讯作者：
Rifai, N