关键词:

H型高血压, 沙库巴曲缬沙坦钠片, 叶酸, 糖脂代谢, 血压, 血管内皮功能

Abstract:

Objective　To observe the effects of sacubitril valsartan sodium tablets combined with folic acid on glucose and lipid metabolism, blood pressure and vascular endothelial function in patients with H-type hypertension. Methods　This study is a randomized controlled trial. Eighty-eight patients with H-type hypertension who were admitted to Tongchuan People's Hospital from April 2022 to April 2024 were selected as the study subjects. Using the random number table method, the patients were divided into the control group and the experimental group, with 44 cases in each group. There were 25 males and 19 females in the control group, aged 45-74 (53.30±7.87) years, body mass index (BMI) 22.87-29.65 (24.85±2.83) kg/m². There were 28 males and 16 females in the experimental group, aged 41-75 (54.68±8.01) years, BMI 22.57-29.41 (24.71±2.43) kg/m². The control group was treated with sacubitril valsartan sodium tablets, while the experimental group was treated with folic acid in addition to the treatment of the control group. Both groups received continuous treatment for 4 months. The glucose and lipid metabolism indicators [fasting blood glucose (FPG), glycosylated hemoglobin (HbAlc), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1)], blood pressure and Hcy levels, vascular endothelial function [vascular dilation function (FMD), intercellular adhesion molecule-1 (ICAM-1), endothelin-1 (ET-1)] were compared before and after treatment in the two groups, as well as clinical efficacy and adverse reactions. Independent sample t test, paired t test, Mann-Whitney U test, χ² test, corrected χ² test, and rank sum test were used for statistical analysis. Results　After treatment, the levels of FPG, HbAlc, TC, TG, and LDL-C in the experimental group were all lower than those in the control group [(4.34±0.89) mmol/L vs. (4.77±0.98) mmol/L, (4.11±0.92)% vs. (4.49±0.81)%, (3.98±0.97) mmol/L vs. (4.42±1.03) mmol/L, 1.03 (1.04, 2.18) mmol/L vs. 1.24 (1.06, 2.16) mmol/L, (2.24±0.71) mmol/L vs. (2.54±0.63) mmol/L], while the levels of HDL-C and ApoA1 were higher than those in the control group [(1.39±0.37) mmol/L vs. (1.22±0.35) mmol/L, (154.69±31.15) mmol/L vs. (135.77±38.11) mmol/L] (all P<0.05); the systolic blood pressure, diastolic blood pressure, and Hcy levels in the experimental group were all lower than those in the control group [(142.27±14.14) mmHg (1 mmHg=0.133 kPa) vs. (148.86±13.07) mmHg, (84.05±9.96) mmHg vs. (89.91±9.98) mmHg, (10.95±2.16) μmol/L vs. (12.32±2.99) μmol/L] (all P<0.05); the FMD level in the experimental group was higher than that in the control group [(5.67±0.74)% vs. (5.09±0.87)%], and the levels of ICAM-1 and ET-1 were lower than those in the control group [(114.63±27.74) μg/L vs. (130.01±31.55) μg/L, (2.23±0.64) ng/L vs. (2.61±0.52) ng/L] (all P<0.05). The total effective rate of treatment in the experimental group was higher than that in the control group [88.64% (39/44) vs. 70.45% (31/44)] (P<0.05); the distribution of treatment effect grades in the experimental group was better than that in the control group (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion　The combination of sacubitril valsartan sodium tablets and folic acid in the treatment of patients with H-type hypertension has a better effect. It can improve glucose and lipid metabolism, vascular endothelial function, lower blood pressure, and has good safety.

Key words: H-type hypertension,  , sacubitril valsartan sodium tablets,  , folic acid,  , glucose and lipid metabolism,  , blood pressure,  , vascular endothelial function