Effect of amlodipine combined with metformin in treatment of patients with obesity-related hypertension
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摘要: 目的 探讨氨氯地平、二甲双胍联合用药对肥胖型高血压患者的临床治疗效果。 方法 将102例肥胖型高血压患者随机分为对照组和研究组,每组51例。对照组采用氨氯地平治疗,研究组在对照组治疗基础上加用二甲双胍进行治疗。比较2组治疗后的临床疗效和治疗前后血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、空腹胰岛素(FINS)浓度,并计算胰岛素敏感指数(ISI), 记录2组治疗前后体质量指数(BMI)、腰臀比(WHR)以及治疗期间不良反应发生情况。 结果 治疗后,研究组的治疗总有效率及HDL-C浓度均显著高于对照组(P<0.05), 血清TC、TG、LDL-C、FBG、HbAlc、FINS水平及ISI、BMI、WHR均显著低于对照组(P<0.05); 2组治疗期间不良反应发生率均较低,且差异无统计学意义(P>0.05)。 结论 与单用氨氯地平比较,氨氯地平联合二甲双胍治疗肥胖型高血压患者的临床疗效更优,可显著改善血脂水平,减轻肥胖程度与胰岛素抵抗,且具有较高的安全性。Abstract: Objective To observe the clinical efficacy of amlodipine and metformin in combination in the treatment of patients with obese-related hypertension. Methods A total of 102 patients with obese-related hypertension were randomly divided into control group and study group, with 51 cases in each group. The control group was treated with amlodipine, while the study group was added with metformin on the basis of the control group. The clinical effects of the two groups after treatment, andconcentrations of serum total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL-C), high density lipoprotein( HDL-C), fasting blood glucose(FBG), glycated hemoglobin(HbAlc), as well as fasting insulin(FINS)were compared. The insulin sensitivity index(ISI)was calculated. The body mass index(BMI), waist-hip ratio(WHR)before and after treatment, and occurrence of adverse reactions during the treatment were recorded. Results After treatment, the total effective rate and HDL-C concentration in the study group were significantly higher than those in the control group(P<0.05). Serum TC, TG, LDL-C, FBG, HbAlc, FINS levels, and ISI, BMI, as well as WHR in the study group were significantly lower than those in the control group(P<0.05). The incidence of adverse reactions during treatment was lower in the two groups, and there was no significant difference(P>0.05). Conclusion Compared with metformin alone, the combination of amlodipine and metformin in the treatment of patients with obese-related hypertension has a better clinical effect, which can improve blood lipid level, alleviate obesity and insulin resistance, and has higher safety in medication.
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Keywords:
- amlodipine /
- combined therapy /
- metformin /
- obese-related hypertension /
- blood lipid /
- insulin resistance
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Schiavon C A, Bersch-Ferreira A C, Santucci E V, et al. Effects of bariatric surgery in obese patients with hypertension: the GATEWAY randomized trial(gastric bypass to treat obese patients with steady hypertension)[J]. Circulation, 2018, 137(11): 1132-1142.
Poulter N R, Dolan E, Gupta A K, et al. Efficacy and safety of incremental dosing of a new single-pill formulation of perindopril and amlodipine in the management of hypertension[J]. Am J Cardiovasc Drugs, 2019, 19(3): 313-323.
Zhou H, Qu Z, Zhang J Z, et al. Antidiabetic effect of ligustilide-rich total lactones derived from Shunaoxin dropping pills on mice with type 2 diabetes induced by a high-fat diet and streptozotocin[J]. RSC Adv, 2016, 6(110): 109132-109142.
Bouhy D, Geuens T, De Winter V, et al. Characterization of new transgenic mouse models for two Charcot-Marie-tooth-causing HspB1 mutations using the Rosa26 locus[J]. J Neuromuscul Dis, 2016, 3(2): 183-200.
程红, 闫银坤, 段佳丽, 等. 儿童肥胖对高血压发病率影响的随访研究[J]. 中华预防医学杂志, 2011, 45(8): 696-701. 周北凡. 我国成人体重指数和腰围对相关疾病危险因素异常的预测价值: 适宜体重指数和腰围切点的研究[J]. 中华流行病学杂志, 2002, 23(1): 5-10. Genovesi S, Antolini L, Giussani M, et al. Hypertension, prehypertension, and transient elevated blood pressure in children: association with weight excess and waist circumference[J]. Am J Hypertens, 2010, 23(7): 756-761.
Coban M, Tasli L, Turgut S, et al. Association of adipokines, insulin resistance, hypertension and dyslipidemia in patients with psoriasis vulgaris[J]. Ann Dermatol, 2016, 28(1): 74-79.
Huby A C, Otvos L Jr, Belin de Chantemèle E J. Leptin induces hypertension and endothelial dysfunction via aldosterone-dependent mechanisms in obese female mice[J]. Hypertension, 2016, 67(5): 1020-1028.
Dempsey P C, Larsen R N, Winkler E A H, et al. Prolonged uninterrupted sitting elevates postprandial hyperglycaemia proportional to degree of insulin resistance[J]. Diabetes Obes Metab, 2018, 20(6): 1526-1530.
张辉, 顾晶. 比索洛尔联合氨氯地平治疗老年冠心病合并高血压患者的疗效分析[J]. 实用临床医药杂志, 2019, 23(2): 29-32. Loh K, Tam S, Murray-Segal L, et al. Inhibition of adenosine monophosphate-activated protein kinase-3-hydroxy-3-methylglutaryl coenzyme A reductase signaling leads to hypercholesterolemia and promotes hepatic steatosis and insulin resistance[J]. Hepatol Commun, 2019, 3(1): 84-98.
Mourad J J, Amodeo C, de Champvallins M, et al. Blood pressure-lowering efficacy and safety of perindopril/indapamide/amlodipine single-pill combination in patients with uncontrolled essential hypertension: a multicenter, randomized, double-blind, controlled trial[J]. J Hypertens, 2017, 35(7): 1481-1495.
马东锋. 二甲双胍联合坎地沙坦应用于肥胖型高血压患者的效果观察[J]. 四川生理科学杂志, 2019, 41(4): 296-298 , 303.
Silverman M G, Ference B A, Im K, et al. Association between lowering LDL-C and cardiovascular risk reduction among different therapeutic interventions: a systematic review and meta-analysis[J]. JAMA, 2016, 316(12): 1289-1297.
Rena G, Hardie D G, Pearson E R. The mechanisms of action of metformin[J]. Diabetologia, 2017, 60(9): 1577-1585.
傅帅. 氨氯地平联合二甲双胍治疗肥胖型轻中度高血压的疗效[J]. 心理月刊, 2019, 14(19): 194-194. Samuel V T, Shulman G I. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux[J]. J Clin Invest, 2016, 126(1): 12-22.
朱琰, 严海风. 二甲双胍和氨氯地平联用治疗肥胖型高血压的meta分析[J]. 中国医药指南, 2018(20): 31-34. Dean A, Nilsen M, Loughlin L, et al. Metformin reverses development of pulmonary hypertension via aromatase inhibition[J]. Hypertension, 2016, 68(2): 446-454.
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