Abstract:Objective: To investigate the effects of atorvastatin and folic acid tablets on homocysteine and carotid atherosclerosis in patients with type H hypertension. Methods: A total of 90 patients with H-type hypertension in the internal medicine clinic of Jieyang Traditional Chinese Medicine Hospital were enrolled. The patients were divided into atorvastatin group, folic acid group and control group by random grouping method. The changes of blood pressure, homocysteine (Hcy), blood lipids, carotid intima-media thickness (IMT), and sputum pulse wave velocity (baPWV) levels were analyzed before and after treatment. And the adverse reactions that occurred were recorded during the treatment. Results: The systolic and diastolic blood pressures of the three groups were significantly lower than those before treatment (P<0.05), and the blood pressure reduction in the atorvastatin group and the folic acid group was significantly better than that in the control group (P<0.05). There was no significant difference in blood pressure (P>0.05). There were no significant differences in Hcy, cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, IMT, and baPWV between the folic acid group and the folic acid group (P>0.05). The level of Hcy, cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, IMT, and baPWV in the atorvastatin group and the folic acid group were significantly improved after treatment (P<0.05), and the atorvastatin group and the folic acid group after treatment. The improvement of each index was significantly better than that of the control group (P<0.05), but there was no significant difference between the two groups (P>0.05). During the treatment, the incidence of adverse reactions in the folic acid group was significantly higher than that in the control group and the atorvastatin group (P<0.05). There was no significant difference in the incidence of adverse reactions between the control group and the atorvastatin group (P>0.05). Conclusion: Adding atorvastatin or folic acid tablets on the basis of conventional antihypertensive therapy can reduce the level of Hcy and the degree of carotid atherosclerosis in patients with H-type hypertension, but atorvastatin is safer and can avoid the shortcomings of folic acid tablets.
张业金, 魏晓娜. 阿托伐他汀与叶酸片对H型高血压患者同型半胱氨酸及颈动脉粥样硬化的影响[J]. 河北医学, 2019, 25(2): 226-228.
ZHANG Yejin, WEI Xiaona. Effects of Atorvastatin and Folic Acid Tablets on Homocysteine and Carotid Atherosclerosis in Patients with Type H Hypertension. HeBei Med, 2019, 25(2): 226-228.
[1] 孙佳艺,巢宝华,徐新娟,等.中国三甲医院高血压患者脑卒中十年发病风险的流行病学研究[J].中华高血压杂志,2014,2(10):964~968. [2] 翟德林,李慧.叶酸干预治疗对H型高血压患者血浆同型半胱氨酸血压水平及主要心脑血管事件的影响[J].山西医药杂志,2015,13(14):1672~1674. [3] 雷蔚,莫新玲,李林健.马来酸依那普利叶酸片对H型高血压降同型半胱氨酸的疗效及安全性[J].医学综述,2015,21(8):1489~1490. [4] 田桂春,郭志保,高龄燕,等.阿托伐他汀钙对H型高血压患者血同型半胱氨酸的影响[J].中国继续医学教育,2017,12(36):78~79. [5] 高耀青,杜媛,吴萌,等.高血压患者同型半胱氨酸水平与代谢综合征及心血管病之间关系的研究[J].心肺血管病杂志,2016,35(12):933~937. [6] Chen Z, Wang F, Zheng Y, et al. H-type hypertension is an important risk factor of carotid atherosclerotic plaques[J]. Clinical & Experimental Hypertension, 2016, 38(5):1. [7] 姜备海.探讨阿托伐他汀用于缺血性脑血管疾病患者二级预防中的临床效果[J].中国实用医药,2016,11(19):187~188. [8] 安妮,张阳,宋沧桑.叶酸代谢相关基因多态性与其个体化补充的研究进展[J].中国药房,2017,28(17):2444~2448. [9] Wu G H, Kong F Z, Dong X F, et al. Association between hyperhomocysteinemia and stroke with atherosclerosis and small artery occlusion depends on homocysteine metabolism-related vitamin levels in Chinese patients with normal renal function[J]. Metabolic Brain Disease, 2017,26(3):1~7. [10] 陆云南,华烨,冯志强,等.依达拉奉联合他汀类药物对缺血性脑卒中患者血清同型半胱氨酸、C反应蛋白、血脂水平的影响[J].实用临床医药杂志,2017,21(19):27~30. [11] Balashenka N, Podpalov V. Individual atorvastatin doses titration to treatment of carotid plaques in patients with arterial hypertension Ⅰ~Ⅱ degree[J]. Atherosclerosis, 2016, 252(1):e187~e187. [12] 陈景生,李波,龙伟东.阿托伐他汀对H型高血压病患者动脉粥样硬化斑块形成的防治作用[J].华夏医学,2017,30(3):5~8.