摘要
目的：通过调查天津市三个级别甲等医院抗高血压药物的使用情况,了解各级医院抗高血压药物的用药特点,分析用药是否合理、是否符合指南要求,为今后抗高血压药物的合理应用和主管部门的监督管理提供科学依据。
方法：回顾性调查天津市三家甲等医院的抗高血压药物应用情况及发展动向。这三家医院包括天津市某三级甲等综合医院(以下简称三甲医院)、天津市红桥区某二级甲等医院(以下简称二甲医院)及天津市河西区某社区医院(以下简称社区医院)。分别调查2009年7-12月份的高血压门诊处方,同时调查三甲医院和二甲医院高血压住院患者的处方情况。统计每位患者的年龄、性别,使用抗高血压药物名称(商品名及化学名)、药物剂量、药物费用、联合用药情况及总的处方量。采用WHO推荐的金额排序法和频度分析法,利用Microsoft Excel2003软件对三家医院抗高血压药物的销售金额、用药频度、日均费用及联合用药情况进行分析,总结并探讨抗高血压药物的用药特点和用药趋势。
结果：
三家医院抗高血压药使用情况,男性稍多于女性,患者的年龄以50-80岁最多。三甲医院门诊常用抗高血压药用药频度排序前五位的依次是：钙通道阻滞剂(CCB)、血管紧张素Ⅱ受体拮抗剂(ARB)、血管紧张素Ⅰ转化酶抑制剂(ACEI)、β受体阻滞剂(β-RB)、和复方制剂；二甲医院门诊常用抗高血压药用药频度排序前五位的依次是：CCB、ACEI、中药制剂、ARB和p-RB；社区医院门诊常用抗高血压药用药频度排序前五位的依次是：CCB、中药制剂、ARB、ACEI、和β-RB。三甲医院门诊常用抗高血压药总金额排序前五位的依次是：CCB、ARB、β-RB、ACEI和复方制剂；二甲医院门诊常用抗高血压药总金额排序前五位的依次是：CCB、ACEI、中药制剂、ARB和β-RB；社区医院门诊常用抗高血压药总金额排序前五位的依次是：CCB、ARB、中药制剂、ACEI和β-RB。药物利用指数(DUI)基本接近于1。
住院患者抗高血压药物使用情况,男性稍少于女性,患者的年龄以60-90岁最多。三甲医院住院患者常用抗高血压药物用药频度排序前五位的依次是：CCB、利尿剂、ACEI、ARB和中药制剂；二甲医院住院患者常用抗高血压药物用药频度排序前五位的依次是：CCB、利尿剂、ACEI、ARB和β-RB。三甲医院住院患者常用抗高血压药物总金额排序前五位的依次是：利尿剂、CCB、α-受体阻滞剂(α-RB)、ACEI和ARB；二甲医院住院患者常用抗高血压药物总金额排序前五位的依次是：CCB、利尿剂、ACEI、ARB和中药制剂。药物利用指数(DUI)基本接近于1。
结论：天津市三家不同级别甲级医院应用抗高血压药物基本合理,其中以CCB、ACEI、ARB、β-RB及利尿剂等几类药物为主。抗高血压药物用药频度在前十几位的药物与广大患者需求及新指南相一致。长效制剂、复方制剂及小剂量联合应用更有利于高血压病的治疗。这三家医院在选择抗高血压药物治疗时基本遵循了科学、安全、有效、适用、经济的原则。抗高血压药品种较多,临床应用广泛,广大临床医生应注意减少不合理用药现象的发生。总之,长效、高效、不良反应少及价格便宜的抗高血压药物将受到就诊患者的欢迎。
Objective:Through investigating the application of antihypertensive drugs in three Class-vary and Grade-A Hospitals in Tianjin, comparing Hypertension Guideline, analyzing the use of antihypertensive drugs in order to provide the scientific basis for the rational use and management of antihypertensive drugs.
Methods:The retrospective investigation in respect of the tendency of using antihypertensive drugs in three Class-vary and Grade-A Hospitals in Tianjin were statistically analyzed from July to December in 2009.The three hospitals include the Class-3 Hospital, Class-2 Hospital and a Community Health Center in Hexi district of Tianjin. The drug utilization including the dates, the patient sex, age, drug name,consumption sum, and the combination drug use of antihypertensive drugs. The money for consume, the defined daily doses (DDDs) and defined daily dose cost (DDDc) were investigated with Microsoft Excel 2003. The utilization characteristics and development trend of antihypertensive drugs were discussed.
Results:
Of the outpatient prescriptions reviewed, three hospitals involved use of antihypertensive drugs, of whom, male represented more than female and antihypertensive drugs were mostly used in patients aged between 50 to 80 years. The classes of antihypertensive drugs in the Class-3 ranked by the defined daily doses (DDDs) were Calcium channel blockers (CCB)、angiogenesisⅡreceptor antagonist (ARB)、angiogenesis converting enzyme inhibitors(ACEI)、β-receptor blockers (B-RB) and compound preparation; Class-2 Hospital:CCB、ACEI、traditional Chinese medicine、ARB、andβ-RB; Community Health Center Hospital:CCB、traditional Chinese medicine、ARB、ACEI and B-RB. The classes of antihypertensive drugs in the Class-3 ranked by the money for consume were CCB、ARB、β-RB、ACEI and compound preparation; Class-2 Hospital:CCB、ACEI、traditional Chinese medicine、ARB andβ-RB; Community Health Center Hospital:CCB、ARB、traditional Chinese medicine、ACEI andβ-RB. Drug utiliztion index (DUI) about is one.
Of the inpatient prescriptions reviewed, three hospitals involved use of antihypertensive drugs, of whom, female represented more than male and antihypertensive drugs were mostly used in patients aged between 60 to 90 years. The classes of antihypertensive drugs in the Class-3 ranked by DDDs were CCB、diuretics、ACEI、ARB and traditional Chinese medicine; Class-2 Hospital:CCB、diuretics、ACEI、ARB andβ-RB. The classes of antihypertensive drugs in the Class-3 ranked by the money for consume were diuretics、CCB、α-RB、ACEI and ARB; Class-2 Hospital:CCB、diuretics、ACEI、ARB and traditional Chinese medicine. Drug utiliztion index (DUI) about is one.
Conclusions:The utilization of antihypertensive drugs were basically reasonable in three Class-vary and Grade-A Hospitals in Tianjin. Keeping good control of blood pressure meanwhile protecting target organs. CCB、ACEI、ARB、β-RB and diuretics dominate in the antihypertensive market in Tianjin. The top more ten of DDDs was in accordance with antihypertensive drugs indicates. Prolonged action preparation、compound preparation and the combination drug use of antihypertensive drugs are helpful for treating hypertensive disease. The doctors of the three hospitals followed scientific, safe and effective, applicable and economical principles in respect of the selection of antihypertensive medications. In line with the domestic and abroad general medication situation, the antihypertensive drugs are characterized by complicated categorization, wide variety, and widespread clinical application. It's necessary to train the physicians to strengthen their sense of responsibilities and reasonable prescriptions, to reduce irrational administration, and to make the service truly patient-oriented. For some time to come, antihypertensive drugs of long-lasting efficiency, less adverse reactions and low cost would be welcome in our hospital, in line with the development trend of antihypertensive drugs.
引文
[1]赵东.加速我国高血压防指南制定的科学化进程[J].中华内科杂志,2004,43(10)：723.
[2]Loyd-Jones D, Adams R, Carnethon M, et al. Heart disease and stroke statistics-2009 update:a report from the American heart association statisics committee and stroke statistics subcommittee. Circulation,2009,119:480-486.
[3]Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide date. Lancet,2005,365:217-223.
[4]Guilbert JJ. World Health Report 2002:Reducing Risks, Promoting Healthy Life. Educ Health (Abingdon),2003,16:230.
[5]Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint Natiomal Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension,2003,42:1206-1252.
[6]中华高血压防治指南修订委员会.中国高血压防治指南(2005年修订版)[J].高血压杂志,2005,134(增刊1)：2-37.
[7]Chobanian AV, Bakris GL, Black HR, el:al. The seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure[J], JAMA,2003,289:2560-2572.
[8]钱存荣,闫双银,王丽芳.目前开展合理用药评估的必要性[J].天津药学,2006,18(1)：74-75.
[9]邹豪,邵元福,朱才娟,等.医院药品DDD数排序分析的原理及利用[J].中国药房,1996,7(5)：215.
[10]国家药典委员会.中华人民共和国药典：临床药须知[M].北京：人民卫生出版社,2005：12.
[11]陈新谦,金有豫,汤光.新编药物学[M].16版.北京：人民卫生出版社,2007：392-406.
[12]张静华.医院药学[M].第一版.北京：中国医药科技出版社,2001：102.
[13]雪君.金额及DDD数排序两种用药分析方法在药物利用研究中的应用及比较[J].中国民康医学,2008,20(14)：1662-1669.
[14]陈新谦,金有豫,汤光.新编药物学[M].第十五版.北京：人民卫生出版社, 2003：324-378.
[15]杨鹏飞,祝莉莎,成杰,等.某院2007-2008年抗菌药物应用分析[J].中国医院用药评价与分析,2008,8(11)：814.
[16]李冬春.2003～2004年我院抗感染药物使用状况分析[J].广东药学.2005,15(3)： 52.
[17]吴润伟,郭海飞,郝红兵,等.北京地区36家医院2005-2007年抗抑郁药利用分析[J].中国药房,2009,20(8)：572.
[18]孙宁玲.2004年中国高血压防治指南修订版的解读[J].高血压杂志,2005,13(6)：378-380。
[19]向志文,钟吉波,刘春英.3482例门诊抗高血压药使用分析.中南药字,2009,7(7)：551-553.
[20]李秀华,陆少峰,黄惠芳.抗高血压药物900例的临床疗效分析[J].吉林医学,2011,32(5)：883-886.
[21]胡波.门诊357例抗高血压药物处方分析[J].海峡药学,22(8)：227-229.
[22]李勇.联合抗高血压药物应成为普通适用的初始治疗策略[J].世界临床药物,2008,29(1)：6-8.
[23]史宇翔,翟所迪.β受体阻断药物利用调查及处方分析[J].中国药师,2002,5(1)：44.
[24]Mancia G, Grassi G. The international nifedipine GITS study of intervention as a goal in hypertension treatment (INSIGHT) trial [J]. Am J Cardiovascular risk treated (INSIGHT) trial [J]. Am J Cardiol,1998,82(9B):23R-28R.
[25]张石革,马国辉.心脑血管疾病治疗药的进展.中国医院用药评价与分析,2006,1(6)：62.
[26]Dahlof B, Devereux R B, Kjeldsen S E,et al. Cardiovascular morbidity and mortality in the losartan intervention for endpoint reduction in hypertension study (LIFE):a randomised trial against atenolol [J]. Lancet,2002,359 (9311):995-1003.
[27]Macmahon S, Neal B, Tzourio C, el al. Randomised trial of a perindopril-based blood pressure lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack [J]. Lancet,2001,358 (9287):1033-1041.
[28]Liu L S, Zhang Y Q, Liu G Z, et al. The felodipine event reduction (FEVER) study:a randomized long-term placebo-controlled trial in Chinese hypertensive patients [J]. J Hypertens,2005,23(12):2157-2172.
[29]王庆礼.门诊高血压患者用药情况调查分析[J].医学信息,2011,1：36-37.
[30]任艳丽,孙楠.高血压用药387例调查分析[J].中国医药,2011,6(2)：345.
[31]Hasebe N, Kikuchi K.Controlled release nifedipine and candesartan low-dose combination therapy in patients with essential hypertension:NICE Combi (Nifedipine and Candesartan Combination) Study [J]. J Hypertens,2005,23 (2):445-453.
[32]Jamerson K, Weber M A, Bakris G L, et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients[J]. N Engl J Med,2008, 359 (23):2417-2428.
[33]龚培力.抗高血压药物的评价与研究进展[J].医学导报,2007,4(26)：334-339.
[34]张石革,陈瑞红,梁建华.二氢吡啶类钙通道阻滞剂控制血压的临床评价[J].中国医院用药评价与分析,2004,4(4)：202.
[35]董超,王来成,朱虹.2008-2009年口服抗高血压类药物应用分析[J].徐州医学院学报,2010,30(6)：382-384.
[36]曲静伟,洪中立.抗高血压药物的评价与选择[J].现代实用医学,2006,18(4)：283.
[37]王宏宇,倪永斌,张维忠,等.血管紧张素转换酶抑制剂对高血压病人心脏和大动脉的影响[J].中国新药与临床杂志,2003,22(6)：361.
[38]吕世文.2006-2008年金华市区部分医院抗高血压药物应用分析[J].药事组织,2010,19(17)：42-43.
[39]吴方建,李爱武.2002-2003年武汉地区部分医院抗高血压药用药分析[J].药物流行病学杂志,2003,12(5)：245.
[40]李斯,鲁春霞.高血压的药物治疗[J].中国现代临床医学,2004,3,(3)：40-41.
[41]杨贵,郭吉蓉,杨大勇.门诊抗高血压药处方分析[J].中国医学创新,2010,7(1)：158-160.
[42]莫明秀.2007-2009年我院抗高血压药物的应用情况分析[J].中国中医药咨询,2010,2(13)：296-297.
[43]康树德.从JNC7和《2003欧洲高血压指南》看利尿剂在高血压治疗中的地位[J].上海医药,2004,25(1)：20.
[44]胡大一.缓释吲达帕胺与培哚普利联合治疗高龄高血压患者显著获益.中国医学论坛报,2008,4：10,c9.
[45]Beckett N S, Peters R, Fletcher A E, et al. Treatment of hypertension in patients
80 years of age or older [J]. N EngL J Med,2008,358 (18):1887-1898.
[46]孙艳,刘萍.我院抗议高血压药物利用分析.中国医院用药评价与分析,2008,8(10)：743-745.
[47]张大禄,范丙义.中药治疗高血压对RAS,血管活性物质影响的研究[J].山东中医杂志,2004,23(1)：701-703.
[48]孙宁玲.从国际高血压指南看钙离子拮抗剂在高血压治疗中的作用[J].中华老年多器官疾病杂志,2003,2(4)：253-256.
[49]乃海燕,毕津莲,李湘斌.门诊抗高血压药处方用药分析[J].南华大学学报医学版,2010,38(2)：232-235.
[50]姚洁.社区卫生服务中心门诊处方抗高血压药物使用调查[J].中国医学创新,2011,8(2)：20-21.
[51]杨国旗.原发性高血压患者药物治疗依从性调查分析[J].中国医药指南,2009,4(7)：40-41.
[1]中华高血压防治指南修订委员会.中国高血压防治指南(2005年修订版)[J].高血压杂志,2005,134(增刊1)：2-37.
[2]叶任高.内科学[M].6版.北京：人民卫生出版社,2005：247-262.
[3]全国高血压抽样调查协作组.中国人群高血压患病率及其变化趋势.高血压杂志,1995,3：57.
[4]荀平.辽宁省农村地区老年人群高血压现状调查.实用老年医学,2008,4(22)：125-127.
[5]Chobanian AV, Bakris GL, Black HR, el:al. The seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure[J], JAMA,2003,289:2560-2572.
[6]Mancia G, De Backer G, Dominiczak A, et al.2007 Guide-lines for the Management of Arterial Hypertension:The Task Force for the Management of Arterial Hypertension of the European society of Hypertension (ESH) and of the European society of Cardiology (ESC) [J].J Hypertension,2007,25(5):1105-1187.
[7]Ogihara T, Kikuchi K, Matsuoka H, et al. Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009)[J].Hypertens Res,2009, 32(1):1-107.
[8]Padwal RS, Hemmelgarn BR, Khan NA, et al. The 2009 Ganadian Hypertension Education Program recommendations for the management of hypertension:Part1-blood pressure measurement, diagnosis ang assessment of rick[J].Can J Cardio,2009,25(5):279-286.
[9]Khan NA, Hemmelgarn B, Herman BJ, et al. The 2009 Cemadian Hypertension Education Program recommendations for the management of hypertension:Part2-therapy[J].Can J Cardiol,2009,25(5):287-298.
[10]Staessen JA, Gasowski J, Wang JG, et al. Risks of untreated and treated isolated systolic hypertension in the elderly:meta-analysis of outcome trials[J]. Lancet,2000, 355(9207):865-872.
[11]吴兆苏.重视高血压患者的总体心血管病危险[J].中华心血管病杂志,2007,35(10)：883-884.
[12]中华高血压防治指南起草委员会.中国高血压防治指南(试行本)[J].高血压杂志,2000,8(1)：103-112.
[13]陈绍行,沈卫峰.高血压治疗现况[J].国际心血管病杂志,2006,33(2)：67-69.
[14]丁国华,高宏,孟松伟.合理用药评价[M].北京：化学工业出版社,2006：138.
[15]李勇.2007欧洲高血压指南-联合抗高血压药物治疗应成为普遍适用临床策略[J].心血管病学进展,2007,28(6)：847.
[16]薛浩,吴海英.最新欧洲高血压指南解读[J].心血管病学进展,2007,28(6)：848.
[17]Wang GL, Li Y, Staessen JA, et al. Anthropometric and lifestyle factors associated with white-coat, masked and sustained hypertension in a Chinese population [J]. J Hypertens,2007,25(12):2398-2405.
[18]Li Y, Staessen JA, Lu L, et al. Is isolated nocturnal hypertension a novel clinical entity? Findings from a Chinese population study [J]. Hypertension,2007, 50(2):333-339.
[19]黄绮芳,李燕,王继光.血压晨峰[J].中华心血管病杂志,2008,36(1)：91-93.
[20]黄绮芳,李燕,陆璐,等.血压晨峰与左室肥厚的关系[J].上海交通大学学报(医学版),2008,28(7)：867-870.
[21]杨宝峰,苏定冯.药理学[M].第6版.北京.人民卫生出版社,2003：254-255.
[22]张劲松.长效钙离子拮抗剂的研究进展[J].中国误诊学杂志,2007,7(3)：437-438.
[23]孙立群,宁桂兰.氨氯地平与依那普利治疗社区老年1、2级高血压的治疗比 较[J].药物与临床,2006,14(5)：552-553.
[24]Brown MJ, Palmer CR, Castaigne A, et al. Morbidity and mortality in patients randomized to double-blind treatment with a long-acting ealcium channel-blocker or diuretic in the international Nifedipine GTTS study:Intervention as a goal of hypertension treatment (IN-SIGHT) [J]. Lancet,2000,356 (9227):366-372.
[25]Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension:principal results of the hypertension optimal treatment (HOT) randomized trial. HOT study group [J]. Lancet, 1998,351(9118):1755-1762.
[26]Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker as diuretic:the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT) [J]. JAMA,2002,288(23):2981-2997.
[27]Epstein M, Compese VM. Evolving role of calcium antagonists in the management of hypertension [J]. Med Clin N Am,2004,88(1):149.
[28JALLHAT. Collaborative research group [J]. JAMA,2002,288:2981-2997.
[29]曹中有,郝江天.苯那普利联合苯磺酸左旋氨氯地平片治疗高血压106例临床疗效观察[J].山西医药杂志,2007,36(3)：274-275.
[30]陈炜,王焱,吴汉宁,等.硝苯地平缓释片对高血压患者血管活性肽的影响及意义[J].中华心血管病杂志,2005,33(1)：89.
[31]孙宁玲,喜阳,荆珊,等.左旋氨氯地平的时间药理学对纠正老年非勺型高血压的作用[J].中华高血压杂志,2007,15(1)：26-29.
[32]许崇德,辛本强,王毅华.非洛地平缓释片治疗老年高血压左室肥厚疗效观察[J].山东医药,2004,44(19)：27.
[33]汪坚勇.非洛地平缓释片对原发性高血压患者肾脏的保护作用[J].临床心血管病杂志,2002,18(8)：365-366.
[34]李俊萍,郭晓华,祁美萍,等.拉西地平对颈动脉内膜-中膜厚度及血管内皮功能的影响[J].中华高血压杂志,2007,15(1)：76-77.
[35]张静,刘详.高血压病人的用药指导[J].社区医学杂志,2006,4(8)：24-26.
[36]王玲.高血压病抗高血压药物的合理应用[J].广西中医学院学报,2000,17(1)：55-56.
[37]王吉云,胡大一,贾三庆.重新评价醛固酮在心血管疾病中的作用[J].中国医刊,2002,37(4)：22.
[38]姚依群.β受体阻滞药在高血压药治疗中的应用及地位[J].武警医学,2008,19(3)：197.
[39]何敏,王秋海,孙爱国.抗高血压药物应用进展[J].临床实践,2005,23(3)；104.
[40]Lindholm LH, Carlberg B, Samuelsson O. Shold βblockers remain first choice in the treatment of primary hypertension? A meta-analysis [J]. Lancet,2005, 366(9496):1545-1553.
[41]Bangalore S, Parkar S, Grossman E,et al. Ameta-analysis of 94 492 patients with hypertension treated with beta blockers to determine the risk of new-onset diabetes mellitus[J]. AM J Cardiol,2007,100(8):1254-1262.
[42]Dahlof B, Sever P S, Poulter NR,et al.Prevention of cardiovascular events an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required,in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm(ASCOT-BPLA):a multicentre randomized controlled trial[J]. Lancet,2005,366(9489):895-906.
[43]Willtams B, Lacy P S,Thom S M, et al. Differential impact of blood pressure lowering drugs on central aortic pressure and clinical outcomes:principal result of the conduit artery function evaluation(CAFE) study [J].Circulation 2006,113 (9): 1213-1225.
[44]O'Rourke MF, Seward J B. Central arterial pressure and arterial pressure pulse: mew views entering the second century after Korotkov [J]. Mayo Clin Proc,2006, 81(8):1057-1068.
[45]Pini R, Cavallini M C, Palmieri V, et al. Central but not brachial blood pressure predicts cardiovascular event in an unselected geriatric population:the ICARe dicomano study [J]. J AM Coll Cardiol,2008,51(25):2432-2439.
[46]Aursnes I, Osnes J B. Atenolol versus other betaadrenergic blockers [J]. J AM
[47]Fragasso G, Cera M, Margonato A. Different metabolic effects of selective and nonselective beta-blockers rather than mere heart rate reduction may be the mechanisms by which beta-blockade prevents cardiovascular events [J]. J AM Coll Cardiol,2009,53(22):2105.
[48]赵玉娟,蔡伟,李庆英.比索洛尔治疗原发性高血压患者的疗效观察[J].天津医药,2006,34(4)：247-249.
[49]宋巧凤,韩素桂,王希柱,等.奈比洛尔对高血压病人血管内皮功能、勃起功能及炎症指标的影响[J].中国老年学杂志,2007,27(5)：486-487.
[50]Olsson G, Wikstrand J, Warnold I, et al. Metoprolol-induced reduction in postinfarction mortality:pooled results from five double-blind randomized trials [J]. Eur Heart J,1992,13(1):28-32.
[51]骆快燕.卡托普利延迟起释型缓释片的研制[J].中国现代应用药学杂志,2005,22(3)：224-228.
[52]路广花.国产赖诺普利治疗轻中重度高血压的临床疗效观察[J].中国保健.药学导刊,2006,14(16)：40-41.
[53]贾院生.赖诺普利治疗原发性高血压病[J].中国临床医学,2006,13(6)：901-903.
[54]张静,刘泽.高血压病人的用药指导[J].社区医学杂志,2006,4(8)：24-26.
[55]Matchar OB, Mccrory DC, Orlando] A, et al. Systematic review:comparative effectiveness of angiotensinconverting enzyme inhibitors and angiotension Ⅱ receptor blockers for treating essential hypertension [J]. Ann Intern Med,2008, 148(1):16-29.
[56]Sawada T, Takahashi T, Yamada H, et al. Rationale and design of the Kyoto Heart Study:effects of valsartan on morbidity and mortality in uncontrolled hypertensive patients with high risk of cardiovascular events [J].Journal of Human Hypertension, 2009,23:188-195.
[57]Mochizuki S, Dahlof B, Shimizu M, et al. Valsartan in a Japanese population with hypertension and other cardiovascular disease (Jikei Heart Study):a randomised, open-label, blinded endpoint morbidity-morality study [J]. Lancet,2007,369: 1431-1439.
[58]Zhu JR, Fujita T, Shimamoto K, et al. Implication of clinical studies for the Asian population:focus on Chinese/Asian population [J]. J Clin Pract,2006,60 (Suppl 150):14-16.
[59]张碧玫,余文博.作用于RAAS的抗高血压药研究进展[J].药学进展,2005,29 (3)：136.
[60]宋绍芳.替米沙坦-telmisartan [J].国外新药介绍,2002,20(1)：5.
[61]奚菁颖,童如镜,宋钟娟等.血管紧张素Ⅱ受体拮抗剂的临床应用进展[J].中国药师,2002,5(1)：308.
[62]另向群.抗高血压新药坎地沙坦研究进展[J].中国药业,2005,14(5)：78.
[63]司延斌.多沙唑嗪控释片临床应用现状及进展[J].临床药物治疗杂志,2007,5(2)：22-24.
[64]Neutel JM. The role of combination therapy in the management of hypertension. Nephrol Dial Transplant,2006,21:1469-1474.
[65]贾会绒.原发性高血压的个体化与联合用药.华北煤炭医学院学报,2008,10(5)：628-629.
[66]Law MR, Moris JK, Wald HJ, et al. Use of blood pressure lowering drugs in the prevention of cardiovascular disease:meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies [J].BMJ,2009,338: 1245-1261.
[67]Wald DS, Law M, Morris JK, et al. Combination therapy versus monotherapy in reducing blood pressure:meta-analysis on 11,000 participants from 42 trials[J]. Am J Med,2009,122(3):290-300.
[68]European Society of Hypertension-European Society of Cardiology Guidelines Committee.2003 European Society of Hypertension-Eurial hypertension. Journal of Hypertension. Journal of Hypertension 2003,21:1011-1053.
[69]黄艾平,钟四凤.治疗原发性高血压药物的调查与分析[J].医学临床研究,2007,24(10)：1698-1700.
[70]周炜,郭小梅.高血压药物治疗进展.医学导报,2010,29(1)：36-39.
[71]许恒忠,李金英.抗高血压药的合理应用[J].中国药物应用与监测,2007,2(6)：53.
[72]Barry L. Carter antihypertensive drug interactions [J]. Drugs of today,2005, 41(1):55-63.