Valsartan combined with amlodipine versus valsartan combined with hydrochlorothiazide in treatment of patients with hypertension

Objective To compare the efficacy and safety of valsartan combined with amlodipine and valsartan combined with hydrochlorothiazide in the treatment of patients with hypertension.

Methods A total of 120 eldely patients with hypertension were randomly divided into observation group and control group.The observation group was treated with valsartan and amlodipine, while the control group was treated with valsartan and hydrochlorothiazide.The changes of 24 h blood pressure, nitric oxide (NO) and endothelin (ET) before and after treatment were compared between the two groups, and the condition of blood pressure reaching standard and adverse reactions of drugs were observed in both groups.

Results There were no significant differences in 24 h systolic blood pressure and diastolic blood pressure before treatment between the two groups (P>0.05);the 24 h systolic blood pressure after treatment in the observation group was (126.5±8.9) mmHg, which was significantly lower than (134.8±9.1) mmHg in the control group (P < 0.05).After treatment, the rates of blood pressure reaching standard in the observation group and the control group were 95.0% and 93.0% respectively.After treatment, the NO levels in the observation group and the control group were (69.6±18.7) and (65.4±15.2)μmol/L respectively, which were significantly higher than (27.5±13.5) and (27.6±13.4)μmol/L before treatment in both groups (P < 0.05);the ET levels were (33.2±4.5) and (37.1±5.4) ng/L in the observation group and the control group, which were significantly lower than (45.5±8.2) and (45.8±8.4) ng/L before treatment in both groups (P < 0.05);serum NO level after treatment in the observation group was significantly higher than that in the control group, and ET was significantly lower than that in the control group (P < 0.05).After treatment, the total incidence rate of adverse reactions in the observation group was 8.3%, which was significantly lower than 16.7% in the control group (P < 0.05).

Conclusion For elderly patients with hypertension, valsartan combined with amlodipine can more effectively control systolic blood pressure, increase serum NO level, reduce ET level and protect vascular endothelial function.