| Purpose To investigate the changes of systolic blood pressure,diastolic blood pressure and homocysteine in patients with H-type hypertension combined with nifedipine controlled-release tablets and folic acid tablets compared with nifedipine controlled-release tablets alone,The effect of the methyltetrahydrofolate reductase gene C677 T polymorphism on the level of homocysteine changes is intended to provide a basis for actively controlling blood pressure levels,controlling risk factors,and provide different treatment options for patients with H-type hypertension.Methods Between August 2017 and August 2018,142 patients with H-type hypertension were enrolled in the Department of Cardiovascular Internal Medicine at the Department of Cardiology,Affiliated Hospital of Qingdao University,including 74 males and 68 females.The patients were divided into observation group and control group by random number table.There were 76 patients in the observation group,include 42 males,66 patients in the control patients,include 34 males.Collect systolic blood pressure,diastolic blood pressure,gender,age and other medical history data before treatment,collect venous blood of patients with fasting for more than 12 hours,collect homocysteine(Hcy),fasting blood glucose(GLU),alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL-C),and low-density lipoprotein(LDL-C),MTHFR C677 T genotype was detected in both groups.The observation group continuously took nifedipine controlled release tablets 30mg/qd(produced by Bayer,Germany),folic acid tablets 2.5mg/qd(Fuzhou Haiwangfu Pharmaceutical)for 4 weeks,and the control group continued to take nifedipine controlled release tablets 30mg/qd(produced by Bayer,Germany)for 4 weeks.After 4 weeks,the systolic blood pressure,diastolic blood pressure and plasma homocysteine levels of the two groups were collected and compared.At the same time,the changes of Hcy levels before and after treatment of different genotypes of CC,CT and TT in the observation group were compared.Results 1.Before treatment,general data of the patients in the observation group and the control group were compared.There were no statistically significant differences in gender,age,fasting blood glucose,alanine glutamate transaminase,glutamate transaminase,creatinine,triglyceride,total cholesterol,high-density lipoprotein and low-density lipoprotein between the two groups(P > 0.05).2.Before treatment,systolic blood pressure,diastolic blood pressure and Hcy levels in the observation group and the control group were higher,and the differences were not statistically significant(P<0.05)After treatment,the systolic blood pressure and diastolic blood pressure in the observation group and the control group were both lower than before,and the blood pressure in the observation group was significantly lower than that in the control group.The difference between the two groups was statistically significant(P<0.05).After treatment,Hcy in the observation group decreased compared with the previous group,and the difference was statistically significant(P<0.05).After treatment,Hcy in the control group was slightly lower than before,and the difference was not statistically significant(P>0.05).After treatment,Hcy levels of the two groups were compared,and the difference was statistically significant(P<0.05).3.The genotypes of MTHFR C667 T in the two groups were CC,CT and TT.The wild-type in the observation group accounted for 42.11%,heterozygous type 32.89%,and mutant type 25%.The wild-type in the control group accounted for 42.42%,heterozygous type 33.33%,and mutant type 24.24%.The genotype frequencies of the two groups were compared,the difference was not statistically significantt(P>0.05).4.Before treatment,the Hcy level of patients with different genotypes was compared,and the difference was not statistically significant(P>0.05).After treatment,Hcy levels were all lower than before,and the difference was statistically significant(P<0.05).The Hcy level of CC and CT patients was compared,and the difference was not statistically significantt(P>0.05).Hcy level of TT type patients was more significant than that of CC and CT type patients,and the difference was statistically significant(P<0.05).Conclusions The antihypertensive effect of nifedipine controlled-release tablets combined with folic acid tablets is more effective than that of nifedipine controlled-release tablets alone.The combination of two drugs can effectively reduce systolic blood pressure,diastolic blood pressure and Hcy levels.In patients with H-type hypertension,the use of nifedipine controlled release tablets alone can not effectively control Hcy levels.The MTHFR C677 T genotypes in the H-type hypertensive population were mainly CC,CT,and TT.Nifedipine controlled release tablets combined with folic acid tablets for different levels of Hcy in patients with different genotypes,TT-type patients have the most significant effect. |
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