• 郫縣人民醫(yī)院心內(nèi)科（四川郫縣，611730）;

【摘要】　目的　 探討阿托伐他汀強化降脂治療和左旋氨氯地平聯(lián)用對高血壓患者血壓的影響。　方法　 選擇2009年1月-2010年11月住院及門診原發(fā)性高血壓合并高脂血癥患者196例，均給予左旋氨氯地平和阿托伐他汀治療8周后，復查血脂，從其中選擇血脂正常者120例，隨機分為對照組（單用左旋氨氯地平組）和治療組（繼續(xù)左旋氨氯地平聯(lián)用阿托伐他?。?，繼續(xù)治療20周后的血壓情況。　結(jié)果　 兩組治療20周后，治療組收縮壓和舒張壓均較對照組下降明顯，組間差異有統(tǒng)計學意義（P lt;0.01），治療組優(yōu)于對照組。　結(jié)論　 高血壓合并高脂血癥患者，使用左旋氨氯地平降壓和阿托伐他汀降脂治療時，在血脂降至正常后，繼續(xù)同時左旋氨氯地平降壓和阿托伐他汀強化降脂治療，降壓效果優(yōu)于單用左旋氨氯地平。
【Abstract】　Objective　 To investigate the effects of levamlodipine combined with atorvastatin on blood pressure in patients with primary hypertension.　Methods　 Between January 2009 and November 2010, 196 patients with hypertension and hyperlipidemia in the outpatient and inpatient departments of our hospital were given levamlodipine and atorvastatin for 8 weeks, after which 120 patients with normal blood lipid were chosen and randomly divided into the control group (treated only by levamlodipine) and the treatment group (treated by levamlodipine combined with atorvastatin). After 20 weeks of the treatment, we observed their blood pressure.　Results　 After twenty weeks of treatment, the diastolic and systolic pressure was significantly lower in the treatment group than that in the control group (P lt;0.01).　Conclusion　 For patients with hypertension and hyperlipidemia who have undergone the treatment by levamlodipine and atorvastatin, after their blood lipid level decreases to normal, the continuous enhanced treatment by the two drugs has a better efficacy compared with the therapy of single levamlodipine in decreasing the blood lipid.

引用本文： 許鋒成,劉天虎,晏明君,曾洪燕,尹曉華,陳蓉,巫萬璽. 阿托伐他汀強化降脂治療和左旋氨氯地平聯(lián)用對高血壓患者血壓的影響. 華西醫(yī)學, 2011, 26(11): 1633-1635. doi: 復制

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2. 　Liao Y, Zhao H,Ogai A, et al. Atorvastatin slows the progression of cardiac remodeling in mice with pressure overload and inhibits epidermal growth factor receptor activation[J]. Hypertens Res, 2008, 31(2): 335-344.
3. 　Paulsen L, Holm C, Bech JN, et al. Eiffects of statins on renal sodium and water handling:acute and short-term eiffects of atorvastatin on renal haemodynamics,tubular function, vasoactive hormones, blood pressure and pulse rate in healthy, normocholesterolemic humans[J]. Nephrol Dial Transplant, 2008, 23(5): 1556-1561.
4. 　Paulsen L, Holst LM, Bech JN, et al. Glomerular filtration rate and blood pressure are unchanged by increased sodium intake in atorvastatin-treated healthy men[J]. Scand J Clin Lab Invest, 2009, 69(3): 323-329.
5. 　Li JJ, Fang CH. C-reactive potein is not only an inflammatory maker but also a direct cause of cardiovascular disease[J]. Med Hypotheses, 2004, 62(4): 499-506.
6. 　趙水平, 胡大一. 心血管病診療指南解讀[M]. 3版. 北京: 人民衛(wèi)生出版社, 2008: 8-39.
7. 　Ge CJ, Lu SZ, Chen YD, et al. Synergistic effect of amlodipine and atorvastatin on blood pressure, left ventricular remodeling and C-reactive protein in hypertensive patients with primary hypercholesterolemia[J]. Heart Vesse1s, 2008, 23(2): 91-95.
8. 　Asher J, Houston M. Statins and C-reactive protein levels[J]. Clin Hypertens (Greenwich), 2007, 9(8): 622-628.
9. 　Castro PF, Miranda R, Verdejo HE. Pleiotropic effects of atorvastatin in heart failure; role in oxidative stress, inflammation, endothelial function, and exercise capacity[J]. J Heart Lung Transplant, 2008, 27(4): 435-441.
10. 　Mondo CK, Yang WS, Su JZ, et al. Atorvastatin prevented and reversed dexamethasone-induced hypertension in the rat[J]. Clin Exp Hypertens, 2006, 28(5): 499-509.
11. 　Rikitake Y, Liao JK. Rho CTPases, statins, and nitric Oxide[J].Circ Res, 2005, 97(12): 1232-1235.
12. 　Borghi C, Prandin MG, Costa FV, et al. Use of stains and blood pressure control in hypertensive patients with hypercholesterolemia[J].J Cardiovase Pharmacol, 2000, 35(4): 549-555.
13. 　Krzesinski JM. Firest evidence of greater cardiovascular protective effects of newer as compared to old antihypertensive drugs ireatments: the ASCOT-BPLA results[J].Rev Med Liege, 2005, 60(10): 820-826.
14. 　Ferrie KE, Muhlmann MH, Baguet JP, et al. Intensive cholesterol reduction lowers blood pressure and large artery stiffness in isolated systolic Hypertension[J]. J Am Coll Cardiol, 2002, 39(6): 1020-1025.
15. 　Golobm BA, Dimsdle JE, White HL, et al. Reduction in blood pressure with stations,results from UCSD Statin Study,a randomized trial[J]. Arch Intern Med, 2008, 168(7): 721-727.
  1. 1. 　Kanbay M,Yildirir A, Bozbas H, et al. Statin therapy helps to controlblood pressure levels in hypertensive dyslipidemic patients[J]. Ren Fail, 2005, 27(3): 297-303.
  2. 2. 　Liao Y, Zhao H,Ogai A, et al. Atorvastatin slows the progression of cardiac remodeling in mice with pressure overload and inhibits epidermal growth factor receptor activation[J]. Hypertens Res, 2008, 31(2): 335-344.
  3. 3. 　Paulsen L, Holm C, Bech JN, et al. Eiffects of statins on renal sodium and water handling:acute and short-term eiffects of atorvastatin on renal haemodynamics,tubular function, vasoactive hormones, blood pressure and pulse rate in healthy, normocholesterolemic humans[J]. Nephrol Dial Transplant, 2008, 23(5): 1556-1561.
  4. 4. 　Paulsen L, Holst LM, Bech JN, et al. Glomerular filtration rate and blood pressure are unchanged by increased sodium intake in atorvastatin-treated healthy men[J]. Scand J Clin Lab Invest, 2009, 69(3): 323-329.
  5. 5. 　Li JJ, Fang CH. C-reactive potein is not only an inflammatory maker but also a direct cause of cardiovascular disease[J]. Med Hypotheses, 2004, 62(4): 499-506.
  6. 6. 　趙水平, 胡大一. 心血管病診療指南解讀[M]. 3版. 北京: 人民衛(wèi)生出版社, 2008: 8-39.
  7. 7. 　Ge CJ, Lu SZ, Chen YD, et al. Synergistic effect of amlodipine and atorvastatin on blood pressure, left ventricular remodeling and C-reactive protein in hypertensive patients with primary hypercholesterolemia[J]. Heart Vesse1s, 2008, 23(2): 91-95.
  8. 8. 　Asher J, Houston M. Statins and C-reactive protein levels[J]. Clin Hypertens (Greenwich), 2007, 9(8): 622-628.
  9. 9. 　Castro PF, Miranda R, Verdejo HE. Pleiotropic effects of atorvastatin in heart failure; role in oxidative stress, inflammation, endothelial function, and exercise capacity[J]. J Heart Lung Transplant, 2008, 27(4): 435-441.
  10. 10. 　Mondo CK, Yang WS, Su JZ, et al. Atorvastatin prevented and reversed dexamethasone-induced hypertension in the rat[J]. Clin Exp Hypertens, 2006, 28(5): 499-509.
  11. 11. 　Rikitake Y, Liao JK. Rho CTPases, statins, and nitric Oxide[J].Circ Res, 2005, 97(12): 1232-1235.
  12. 12. 　Borghi C, Prandin MG, Costa FV, et al. Use of stains and blood pressure control in hypertensive patients with hypercholesterolemia[J].J Cardiovase Pharmacol, 2000, 35(4): 549-555.
  13. 13. 　Krzesinski JM. Firest evidence of greater cardiovascular protective effects of newer as compared to old antihypertensive drugs ireatments: the ASCOT-BPLA results[J].Rev Med Liege, 2005, 60(10): 820-826.
  14. 14. 　Ferrie KE, Muhlmann MH, Baguet JP, et al. Intensive cholesterol reduction lowers blood pressure and large artery stiffness in isolated systolic Hypertension[J]. J Am Coll Cardiol, 2002, 39(6): 1020-1025.
  15. 15. 　Golobm BA, Dimsdle JE, White HL, et al. Reduction in blood pressure with stations,results from UCSD Statin Study,a randomized trial[J]. Arch Intern Med, 2008, 168(7): 721-727.