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目的探讨血脂康在合并高血压患者中的冠心病二级预防效果。方法对一项随机、双盲、安慰剂对照试验中的2704例合并高血压、2166例不合并高血压的冠心病患者的干预结果进行分析,并对高血压患者按照脉压分组进行统计。结果冠心病合并高血压患者的冠心病事件的发生率和总死亡率明显高于不合并高血压的患者。在合并高血压患者中,高脉压组(脉压>50 mm Hg,1mm Hg=0.133 kPa)患者的死亡率和脑卒中发生率明显高于低脉压组(脉压≤50 mm Hg)患者。与对照组比较,冠心病事件和总死亡率在合并高血压患者中分别降低44.0%(P<0.0001)和35.8%(P=0.0012),在不合并高血压患者中分别降低47.4%(P<0.0001)和28.6%(P=0.0737)。在全部合并高血压的患者中,肿瘤死亡减少67.5%(P=0.0071)。在低脉压组患者中,肿瘤事件减少62.6%(P=0.0399)。没有发现治疗组临床不良反应或实验室安全指标的增加。结论对冠心病合并高血压的患者应积极进行调脂治疗,血脂康用于高血压患者的冠心病二级预防是安全有效的。
Objective To investigate the secondary preventive effect of Xuezhikang on coronary heart disease in patients with hypertension. Methods The results of a randomized, double-blind, placebo-controlled trial of 2704 patients with hypertension and 2166 patients with coronary artery disease without hypertension were analyzed and statistically analyzed for patients with hypertension according to pulse pressure grouping. Results The incidence of coronary heart disease and total mortality in patients with CHD and hypertension were significantly higher than those without hypertension. Among patients with hypertension, the incidence of death and stroke in patients with high pulse pressure (pulse pressure> 50 mm Hg, 1 mm Hg = 0.133 kPa) was significantly higher than those in patients with low pulse pressure (pulse pressure ≤50 mm Hg) . Compared with the control group, the incidence of coronary heart disease and total mortality were decreased by 44.0% (P <0.0001) and 35.8% (P = 0.0012) in patients with hypertension, respectively, and decreased by 47.4% in patients with hypertension without hypertension (P < 0.0001) and 28.6% (P = 0.0737). In all patients with hypertension, there was a 67.5% reduction in tumor death (P = 0.0071). Tumor events were reduced by 62.6% in patients with low pulse pressure (P = 0.0399). No increase in clinical adverse events or laboratory safety was noted in the treatment group. Conclusions Patients with coronary heart disease complicated with hypertension should be actively treated with lipid-lowering therapy. Xuezhikang is safe and effective for secondary prevention of coronary heart disease in hypertensive patients.