工作场所干预条件下不同药物组合的降压效果

Effectivess of different drug combinations on the control of hypertension under workplace intervention

  • 摘要: 目的比较分析工作场所干预条件下,不同药物组合对高血压患者的降压效应。方法 2009-04-2010-05对开滦集团有限责任公司井下及井下辅助单位在岗患高血压的职工进行综合干预共5367例,其中男性4023例,女性67例,年龄(45.5±6.5)岁。干预措施包括免费发放降压药物,宣传教育和行政干预。免费发放的降压药为下列组合之一:①尼群地平5mg2次/d+卡托普利12.5mg2次/d(A组,1115例);②尼群地平5mg2次/d+螺内酯20mg1次/d(B组,704例);③氢氯噻嗪12.5mg1次/d+卡托普利12.5mg2次/d(C组,794例);④氢氯噻嗪12.5mg1次/d+螺内酯20mg1次/d(D组,1477例)。干预期间每2周随访1次并测量血压,观察干预前后的血压变化情况。结果干预后收缩压(134.1±13.1)比(147.6±17.5)mmHg、舒张压(86.6±8.9)比(96.9±10.9)mmHg下降(均P<0.01)。A、B、C、D组收缩压分别下降(14.1±23.3)、(11.4±23.0)、(12.1±21.7)和(14.8±20.9)mmHg,舒张压分别下降(9.5±15.5)、(7.4±14.8)、(10.2±14.4)和(12.1±13.6)mmHg,组间比较差异有统计学意义(均P<0.01),D组血压下降值大于其他组。A、B、C、D组的总有效率分别为67.0%、62.9%、68.5%和77.3%,D组的总有效率高于其他组(P<0.01)。结论工作场所不同抗高血压药物组合能有效降低高血压患者的血压水平。

     

    Abstract: Objective To exam the effects of different drug combinations on the control of hypertension in workplace. Methods Beginning from April, 2009, the active workers with hypertension received comprehensive hypertension treatments. Patients were either underground or supporting workers from Kailuan Group. Anti-hypertension drugs were distributed freely. Patients received one of the following combinations: 1. nitrendipine 5 mg 2/d plus captopril 12.5 mg 2/d, or 2. nitrendipine 5 mg 2/d plus spirolactone 20 mg 1/d, or 3. hydrochlorothiazide 12.5 mg 1/d plus captopril 12.5 mg 2/d or 4. hydrochlorothiazide 12.5 mg 1/d plus spirolactone 20 mg 1/d. Patients also received health education and administrative intervention. During the treatment period, blood pressure were measured every two weeks. Results After treatment, patients obtained significant reduction in both SBP (134.1±13.1) vs (147.6±17.5)mm Hg and DBP (86.6±8.9) vs (96.9±10.9) mm Hg (all P<0.01). SBP reduced (14.1±23.3), (11.4±23.0), (12.1±21.7) and (14.8±20.9)mm Hg; DBP (9.5±15.5), (7.4±14.8), (10.2±14.4) and (12.1±13.6)mm Hg respectively in nitrendipine/captopril, nitrendipine/spirolactone, hydrochlorothiazide/captopril and hydrochlorothiazide/spirolactone group. The degree of BP reduction in hydrochlorothiazide/spirolactone was larger than other groups. The effective rates were 67.0%, 62.9%, 68.5% and 77.3% respectively in nitrendipine/captopril, nitrendipine/spirolactone, hydrochlorothiazide/captopril and hydrochlorothiazide/spirolactone group. The effective rate in hydrochlorothiazide/spirolactone group was higher than other groups (P<0.01). Conclusion The hypertension treatments with different drug combinations can effectively reduce blood pressure in the workplace.

     

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