沙库巴曲缬沙坦钠治疗难治性高血压的临床观察OACSTPCD

Objective To investigate the effectiveness and safety of sacubitril/valsartan sodium in the treatment of resistant hypertension.Methods One hundred patients with resistant hypertension at Putuo Hospital,Shanghai University of Traditional Chinese Medicine from January 2020 to December 2021 were randomly selected.After a 4-week drug washout period,they were divided into two groups(the treatment group and control group)of 50 each using the random envelope method.The treatment group received sacubitril/valsartan sodium 200 mg/d,amlodipine besylate tablet 5 mg/d,and hydrochlorothiazide 12.5 mg/d,while the control group received valsartan 80 mg/d,amlodipine besylate tablet 5 mg/d,and hydrochlorothiazide 12.5 mg/d.The treatment duration was 8 weeks.The study observed 24-hour ambulatory blood pressure,clinic blood pressure values,and echocardiographic parameters.Results After treatment,office systolic blood pressure,office diastolic blood pressure,24-hour average systolic blood pressure,24-hour average diastolic blood pressure,daytime average systolic blood pressure,daytime average diastolic blood pressure,as well as nighttime average systolic blood pressure and nighttime average diastolic blood pressure in the treatment groups were decreased compared with those in the control group,the differences were statistically significant(t=-5.204,-3.166,-5.521,-3.019,-4.325,-2.435,-6.042,-4.968;P<0.05);left ventricular ejection fraction was improved,the difference was statistically significant(t=2.411,P<0.05).The 24-hour average blood pressure control rate was 52%for systolic blood pressure(26 cases)and 82%for diastolic blood pressure(41 cases),which were higher than those in the control group,the difference was statistically significant(χ2=4.110,P<0.05).Conclusion Sacubitril/valsartan sodium combined with antihypertensive treatment of resistant hypertension has better antihypertensive effect,can significantly increase blood pressure control rates,and may offer better cardiac protective effects.