The Effect Of Antihypertensive Treatment And Prevent For Stroke With Hydrochlorothiazide, Nitrendipine And Captopril

BackgroundHypertension is a normal disease in china.The prevalence of hypertension is high, One of the most important complications is stroke.Both of the prevalence of disability and death are high.About 2/3 of the CVD accidents are related to hypertension.So, antihypertensive treatment is a good way to prevent stroke.The incidents of hypertension and stroke are high in Fuxin,Liaoning,Province.An epidemiology investigation was carried out in the population aged≥35 years old in this area,and interventional measurement study was held in hypertension population,including healthy education,lifestyle improvement,drug treatment and so on.The aim of this study is to find an economic effective antihypertensive treatment method,and elevate the prevalence of control hypertension and decrease the prevalence of stroke.Method45925 persons aged 35 years or older were selected by a cluster sample method from 8 towns in rural Fuxin randomly.The investigation was carried out face-to-face by training doctors using standardized method with unified questionnaire.The questionnaire included lifestyle characteristics,information about alcohol consumption, smoking,dietary habits,medical history.Physical conditions such as height,weight and blood pressure were measured.Blood pressure measurement was using electronic manometer OMRON 741C.According to Chinese guideline for prevention and treatment of hypertension(2005 version),the hypertension was defined that SBP≥140mmHg or/and DBP≥90mmHg,or having antihypertensive drug at present.According to selecting standard and removing standard,all the subjects were divided into a reinforced intervention group and an ordinary intervention group.The ordinary intervention group was given healthy education,lifestyle improvement, including stop smoking and drinking,decreasing cholesterol and salt intake,exercises and so on.Except above intervention,the ordinary intervention group was given antihypertensive treatment.Blood samples of all the subjects were collected at baseline. During the follow-up,blood pressures were measuring every two months,and investigate the prevalence of hypertension control and stroke.According to blood pressure lever,we adjust the antihypertensive drugs.All the information was input with Epidata 3.1 software and analyses with SPSS11.0 software.Measurement data was analyses by t-test,enumeration data was analyses byχ2 test.Results4660 un-control hypertension subjects were selected,2321 in reinforced intervention group and 2339 in ordinary intervention group.After 15 months follow-up, the blood pressure decreased 16.89/9.83 mmHg in reinforced intervention group;the prevalence of hypertension control was 33.1%(male 30.3%,female 35.4%).The blood pressure decreased 3.22/4.34 mmHg in ordinary intervention group,the prevalence of hypertension control was 13.9%.There were 22 stroke incidents in reinforced intervention group,the prevalence of stroke was 0.95%.There were 50 stroke incidents in ordinary intervention group,the prevalence of stroke was 2.14%.After antihypertensive treatment,the risk of stroke decreased 58%.ConclusionThe study indicated that based on diuretic,CCB and ACEI decreased the blood pressure and increased the prevalence of hypertension control,conspicuously.After antihypertensive treatment,the prevalence of stroke decreased conspicuously.The treatment method was economic and effective.It was suitable to be carried out in the rural areas.