The Clinical Efficacy And Safety Of Plendil And Jiangzhiruanmai Tablets In Patients With Essential Hypertension

Objective : To assess the antihypertensive effect and symptom effect and safety and insulin resistance of plendil (felodipine sustained release tablets) and jiangzhiruanmai tablets in treatment of essential hypertension(EH) for four weeks. And investigate the relationship between the hypertensive and obesity patients and insulin resistance(IR).Methods: A open-labeled study was conducted. Thirty patients in sixty with systolic blood pressure(SBP) 140-180mmHg and diastolic blood pressure(DBP) 90-110mmHg were treated with plendil and jiangzhiruanmai tablets the dosage of plendil was one tablet (2.5mg) per day ,and the dosage of jiangzhiruanmai tablets was six tablets per time, three times per day. Other thirty patients were only treated with plendil, the dosage was 2.5mg per day. The antihypertensive effect and symptom effect and IR's effect were observed. In the meantime according to body mass index (BMI), a total of 60 patients with EH were divided into normal body weight group and obesity group. Fasting insulin(FIN) and fasting plasma glucose(FPG) were performed and insulin resistance index (HOMA-IR) was calculated in all patients, then analyzing the relationship between hypertensive obesity patients and IR.Results: (l)Compared with the baseline afterward, the SBP and DBP of treatment group and control group significantly decreased after taking medicines. The antihypertensive peak of two group is after one week. , the SBP and DBP of treatment group respectively decreased 13.7mmHg and 10.5mmHg, control group decreased ll.SmmHg and 7 mmHg respectively. After four week's treatment, , the SBP and DBP of treatment group is respectively 2mmHg lower than one week , but control group hardly change.(2) Significant difference was founded between treatment group and control group in symptom effect. The total effective rate of treatment group is 90.00%, but control group is only 56.67%. (3) Compared with the normal body weight group, height and FPG in the obesity group weren't higher and no difference was observed (p>0.05). But BMI, FIN and HOMA-IR in the obesity group is higher than those innormal body weight group and significant difference was founded (PO.05, PO.01, P<0.01). (4) Before treatment HOMA-IR in treatment group and control group is respectively 4.91?.89mmolmU/L2x 4.80?.09 mmolmU/L2, after taking medicines is respectively 4.57?.94 mmolmU/L2, 4.61?.21 mmolmU/L2. From data, although no difference was observed, the effect of treatment group is better than control group. (5) Side effect occurred is 2 cases during four week's treatment. No severe side effect occurred.Conclusions: (l)Plendil and jiangzhiruanmai tablets in treatment of hypertension is better than only plendil, especially significant difference was observed in symptom effect (p<0.01). This showed jiangzhiruanmai tablets has remarkable advantage in improving symptom of patients with hypertension. (2)Plendil and jiangzhiruanmai tablets can remarkably and safely reduce blood pressure.(3) From data, plendil and jiangzhiruanmai tablets is better than only plendil in improving IR. (4) The obesity is one of factors in inducing HOMA-IR with EH.