培哚普利:高血压治疗的最新综述。
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赫斯特M，贾维斯B
培哚普利:高血压治疗的最新综述。
药。2001;61(6):867 - 96。
- PubMed ID
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11398915 (在PubMed］
- 摘要
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培哚普利厄布明(Perindopril erbumine)是血管紧张素转换酶(ACE)抑制剂培哚普利的前药酯。每日一次的培哚普利4 ~ 8毫克可显著降低高血压患者的仰卧收缩压(SBP)和舒张压(DBP)的基线值。这些降低至少维持24小时，波谷/峰值比为>50%证明了这一点。与高血压相关的血管异常在培哚普利治疗期间得到改善或恢复正常。Perindopril每日1次，4 ~ 8 mg显著降低颈动脉-股主动脉脉搏波速度(PWV)，改善动脉依从性，降低左心室质量指数，并且，在近期脑缺血和/或中风患者中，尽管显著降低收缩压和舒张压，但保留了脑血流。主动脉PWV降低与终必威国际app末期肾衰竭患者死亡率降低相关，其中三分之一的终末期肾衰竭患者接受培哚普利治疗，需要进一步的研究来确定这一有希望的结果的意义。在3个随机双盲试验中，有效率(仰卧舒张压<或= 90mmhg的患者数量)明显高于每日1次4 ~ 8 mg的培哚普利(67 ~ 80%)，高于每日2次25 ~ 50 mg的卡托普利(44 ~ 57%)。在其他临床试验中，培哚普利的降压效果与其他ACE抑制剂(包括依那普利)和钙通道拮抗剂相似。perindopril和另一种降压药的联合治疗提供了额外的好处，无论是作为一线治疗还是对单一治疗无效的患者。培哚普利单药治疗对老年人和高血压及伴随疾病的患者也有效。 Perindopril has a similar adverse event profile to that of other ACE inhibitors; cough is the most common event reported during treatment, and is also the most common adverse event responsible for treatment withdrawal. CONCLUSIONS: Perindopril is a well tolerated ACE inhibitor that is significantly better than captopril (in terms of response rates) in the treatment of hypertension, and as effective as other ACE inhibitors. Perindopril appears to reverse some of the vascular abnormalities associated with hypertension, including arterial stiffness and left ventricular hypertrophy, although further research is needed to confirm promising results regarding its ability to decrease associated cardiovascular morbidity and mortality. Results from ongoing studies will help confirm the place of perindopril in the treatment of hypertension; currently, it is an effective and well tolerated treatment for patients with mild to moderate essential hypertension.
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