缬沙坦-365心血管网.ppt

* 2009年12月发表的一项大型Meta 分析比较了单片复方制剂与自由联合降压药物对于降压治疗依从性、疗效、安全性方面的优势。纳入了32331名患者，15个研究。涉及17999名患者的2个研究证实，SPC与自由联合相比可以显著提高患者治疗依从性(odds ratio: 1.21 [95% CI: 1.03 to 1.43]; P0.02) ；1775名患者的5个研究证实，SPC药物较自由联合有减少不良事件的趋势(odds ratio:0.80 [95% CI: 0.58 to 1.11; P0.19])；SPC较自由联合有更好的降压疗效趋势(SBP/DBP 4.1/3.1mmHg, [SBP 95% CI: 9.8 to 1.5; P0.15; DBP 95% CI: 7.1 to 0.9; P0.13 ])。. Meta分析证实，与自由联合相比，SPC可以显著提高治疗依从性，并有减少不良事件和增强降压疗效的趋势。 Reference Ajay K. Gupta,Compliance, Safety, and Effectiveness of Fixed-Dose Combinations of Antihypertensive Agents A Meta-Analysis. Hypertension. 2010;55:00-00. * This slide shows adverse events reported with Amlodipine/Valsartan, compared with its monotherapy components in a double-blind, placebo-controlled safety population (N=3,155). As a result of its complementary mechanisms of action, the incidence of peripheral edema was demonstrated to be significantly lower with Amlodipine/Valsartan compared with amlodipine monotherapy (5.4% vs 8.7%, respectively; p=0.0138, an overall difference of 38%). Furthermore, there was a similar frequency of overall adverse events with Amlodipine/Valsartan compared with component monotherapies and placebo. Reference Philipp T, et al. Two multicenter, 8-week, randomized, double-blind, placebo-controlled, parallel-group studies evaluating the efficacy and tolerability of amlodipine and valsartan in combination and as monotherapy in adult patients with mild to moderate essential hypertension. Clin Ther 2007;29:563–80. 氨氯地平或缬沙坦单药治疗不达标患者，倍博特 ?:显著降低收缩压 研究设计: 随机, 双盲, 多中心, 平行对照试验 主要终点: 8周治疗后血压达标率 研究对象：氨氯地平5mg或缬沙坦80mg单药治疗4周不达标 290 290 N= ?7.6 ?12.2* -15 -10 -5 0 Amlo5 80/5 Amlo/Val Amlo/Val 80/5 N= 273 267 274 ?6.2 ?7.9 ?12.6? Val 80 Val 160 缬沙坦/氨氯地平较氨氯地平单药显著降低收缩压 缬沙坦/氨氯地平较缬沙坦单药 显著降低收缩压 *P0.0001，与氨氯地平单药治疗组相比；?与缬沙坦80mg和160mg单药治疗相比 诸骏仁* 等 中华心血管病杂志2009.37;794-6 总 b-blocker CCB ARB ACEI 利尿剂 随机治疗试验前应用的降压药种类 治疗8周后与基线比收缩压压水平变化 (mmHg) 随机, 双盲, 多国, 平行对照研究, 治疗8周 倍博特?对单药治疗失败患者进一步降压21mmHg 缬沙坦/氨氯地平 160/10 mg 缬沙坦/氨氯地平 160/5 mg N