Curative Effect Of Candesartan And Felodipine In The Treatment Of Essential Hypertension

Hypertension is characterized by a inceased systemic arterial pressure.It maybe caused by multiple genes,the environment and the interaction of a variety of risk factors.Over the past 20 years,the incidence of hypertension in China showed a rising trend,with the "three high and three low" characteristics,namely,the prevalence, morbidity,mortality are high and the awareness,treatment and control rates are low.At present,China's total population prevalence rate is about 11.26%over 1991years rose by 20 per cent.There are about 160 million patients with hypertension in national estimately.Recent surveys have shown that,the crowd of hypertension awareness, treatment and control rates were 30.2%,24.7%and 6.1%,still at the level of poor,it is worth attention.According to the current research findings,found that the mechanisms of hypertension maybe have of relation of the following six factors:sympathetic activity accentuated, RAAS,kidney retented excessive sodium,vascular reconstruction, endothelial cell dysfunction and insulin resistance.Hypertension's main pathological changes were artery disease and left ventricular hypertrophy,with the progress of disease,heart,brain,kidney,eye, and other important organs can be involved,and therefore its structure and function change different degrees,in serious cases,it can cause myocardial infarction,cerebral ischemia and cerebral vascular accident,renal failure,decreased vision and so on.With the accelerated process of aging of our population,how to effective control of blood pressure has become the focus of widespread attention.Treatment of hypertension in the past merely to reduce the degree of hypertension,as more and more study about the hypertension,now the focus of the study is to reduce high blood pressure on the target organ damage,such as cardiac hypertrophy, kidney failure,stroke and so on.In order to prevent hypertension on target organ damage,ACEI drugs have emerged.But because of its role in the mechanism of restrictions,resulting in cough,the side effect is common in clinical,up to 10-20 per cent,many patients can not tolerate.At the same time there are more rare vascular edema, hyperkalemia,renal injury has been aggravated with impaired renal function and will add a degree of hypotension,with time lasping, despite the application of the ACEI,ATII level was still higher,the existence of such phenomena escape.These are a certain extent to limite the ACEI's applications.According to the mechanism of drug, ARB drugs can make up for ACEI drugs'shortcomings,while avoiding the occurrence of the side effect.Objective:Curative effect of candesartan and felodipine in the treatment of essential hypertension.Methods:Mild to moderate hypertensive patients were randomly divided into two groups,taking Candesartan and felodipine antihypertensive treatment.Patiens were observed(hand test)blood pressure after 1week,2 weeks,4 weeks and 8 weeks.Of these,36 patients at the of the elution and the end of the 8 weeks were monitored by 24 hours of ambulatory blood pressure(ABPM). Observed after 8 weeks,the 24-hour day'night systolic/diastolic blood pressure(SBP/DBP)than wash-effect will be observed,so does the reduction of systolic and diastolic blood pressure of the trough/peak ratio.Before and after the treatment,the heart rate,blood examination, urine examination,blood biochemistry ALT,AST,urea nitrogen,creatinine,blood ions,blood glucose,cholesterol and triglycerides wil be observated.Results:The results of this study showed that the blood pressure of the candesartan group and the felodipine group was decreased significantly after treatment,the andesartan group(hand test:from the pre-treatment(151.98±8.31/97.58±5.36)mmHg to the after-treatment (127.05±7.04/81.88±8.64)mmHg,the difference is(24.93±9.68 /15.70±7.59)mmHg;ABPM:from(153.61±10.85/96.80±12.37)mmHg to(129.43±10.23/77.26±11.84)mmHg,the difference is(24.18±11.71/ 18.74±10.68)mmHg and the felodipine group(hand test:from the pre-treatment(153.35±9.60/97.95±5.11)mmHg to the after-treatment (128.08±8.19/82.83±7.64)mmHg,the difference is(25.27±9.15/ 15.12±6.42)mmHg;ABPM:from(154.12±11.39/95.01±13.55)mmHg to(131.48±10.41/78.2±10.17),the difference is(22.64±10.94/ 16.81±11.74)mmHg..Both hand test or ABPM measured blood pressure,all have significant antihypertensive effects. Antihypertensive efficacy of the two groups were compared within a significant statistical significance(P＜0.01),and between the two groups was not significant(P＞0.05).Before and after treatment heart rate and blood tests have no statistical significance(P＞0.05).A group according to a daily oral dose is divided into 2 groups: 4mg group(n=29 cases)and 8 mg group(n=11 cases).The results showed that the two groups were significantly decreased blood pressure.1)Hand test group:4 mg group:the blood pressure lowered form(152.20±8.95)/(96.3±4.49)mmHg to(129.55±6.00)/(82.69±8.67) mmHg,the difference is(26.65±7.26/13.61±10.24)mmHg.8mg blood pressure from(157.45±7.42)/(101.00±6.15)mmHg to(124.55±9.55)/ (79.10±8.65)mmHg,the difference is(32.90±8.91/21.90±6.09) mmHg.The blood pressure of both two group have decreased,there is the significant differences(P＜0.01).Between the two groups there is the significant differences(P＜0.01).(2)ABPM Group:A total of 36 cases of patients with the observation,in 4mg group of 26 patients'blood pressure from(153.36±8.21)/(94.42±6.69)mmHg to (129.27±5.97)/(81.07±9.02)mmHg,the difference is(23.09±8.26)/ (13.85±11.65)mmHg.8mg group of 10 patients' blood pressure from (158.05±5.39)/(99.20±7.54)to(123.20±7.33)/(77.78±6.42)mmHg, the difference is(34.85±9.20)/(22.26±8.49)mmHg.The blood pressure both of two group have decreased,there is the significant differences (P＜0.01).Between the two groups there is the significant differences (P＜0.01).B group according to a daily oral dose is divided into 2 groups: 5mg group(n=26 cases)and 10 mg group(n=14 cases).The results showed that the two groups were significantly decreased blood pressure.1)Hand test group:5 mg group:the blood pressure lowered from(151.62±9.30)/(96.19±4.40)mmHg to(126.19±8.15)/ (82.85±3.98)mmHg,the difference is(25.43±9.97/13.34±8.32) mmHg.10mg blood pressure from(156.57±9.64)/(101.21±4.85) mmHg to(131.57±7.28)/(81.50±12.26)mmHg,the difference is (25.00±12.36/19.71±7.80)mmHg.The blood pressure of both two group have decreased,there is the significant differences(P＜0.01). Between the two groups there is the significant differences(P＜0.01). (2)ABPM Group:A total of 34 cases of patients with the observation, in 5mg group of 23 patients'blood pressure from(139.80±9.47)/ (89.27±10.05)mmHg to(127.71±8.27)/(82.19±10.46)mmHg,the difference is(12.09±7.86/6.08±8.64)mmHg.10mg group of 11patients'blood pressure from(147.63±7.39)/(94.34±6.36)to (124.85±9.05)/(75.51±8.22)mmHg,the difference is(22.78±7.35/ 18.83±9.27)mmHg.The blood pressure both of two group have decreased,there is the significant differences(P＜0.01).Between the two groups there is the significant differences(P＜0.01).The heart rate of candesartan group before the treatment was (75.85±12.60)/min,8 weeks later was(78.48±9.83)/min;in felodipine group,the before heart rate was(77.97±11.64)/points,8 weeks later was(79.87±10.08)times/min,the heart rate showed no significant difference neither before and after the treatment(P＞0.05).Two groups of the heart rate,blood examination,urine examination,blood biochemistry ALT,AST,urea nitrogen,creatinine,blood ions,blood glucose,cholesterol and triglycerides were no significant statistical difference.Conclusion:Candesartan and Felodipine have the exact effect of lowing the blood pressure.But there is no significant statistical difference between two kinds of drugs.With the doses increasing,the effect of lowing the blood pressure is enhanced,it has the flexibility in dose.The candesartan and felodipine have nothing side effect on the heart rate,blood examination,urine examination,blood biochemistry ALT,AST,urea nitrogen,creatinine,blood ions,blood glucose, cholesterol,triglycerides.Both of two drugs are effective,safe,reliable,convenient.