|
|
|
| Effects of Different Doses of Metoprolol Tartrate Combined with Basic Treatment on Cardiac Function and Heart Rate Variability in Elderly Patients with Conventional Hypertension and Heart Failure |
| SUN Yanpeng1, ZHU Yinchuan2 |
1. Guyang Town Health Center, Lankao Henan 475312; 2. the Second Affiliated Hospital of Zhengzhou University, Zhengzhou Henan 450000 |
|
|
|
|
Abstract 【Objective】 To investigate the effects of different doses of metoprolol tartrate combined with basic treatment on cardiac function and heart rate variability in elderly patients with hypertension and heart failure. 【Methods】 A retrospective analysis was conducted on the clinical data of 104 elderly patients with hypertension and heart failure admitted to two hospitals from June 2022 to February 2025. According to the different dosages of metoprolol tartrate administered, patients were divided into a low-dose group (conventional anti-heart failure basic treatment regimen + low-dose metoprolol tartrate) and a high-dose group (conventional anti-heart failure treatment regimen + high-dose metoprolol tartrate), with 52 cases in each group. The clinical efficacy, blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], heart rate (HR), laboratory indicators [brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP)], cardiac function indicators [left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), left ventricular end-systolic dimension (LVESD)], heart rate variability indicators [standard deviation of the average normal-to-normal intervals for all 5-minute segments over 24 hours (SDANN), root mean square of successive differences between adjacent normal-to-normal intervals (RMSSD), standard deviation of all normal-to-normal intervals over 24 hours (SDNN)], and adverse reactions were compared between the two groups. 【Results】 The total effective rate in the high-dose group was 92.31% (48/52), which was higher than 75.00% (39/52) in the low-dose group, and the difference was statistically significant (χ2=4.500, P<0.05). After treatment, HR, SBP, and DBP in both groups were lower than before treatment, and those in the high-dose group were lower than in the low-dose group, with statistically significant differences (P<0.05). Serum BNP and hs-CRP levels in both groups were lower than before treatment, and those in the high-dose group were lower than in the low-dose group, with statistically significant differences (P<0.05). LVESD and LVEDD in both groups were lower than before treatment, while LVEF was higher than before treatment; moreover, LVESD and LVEDD in the high-dose group were lower than in the low-dose group, and LVEF was higher than in the low-dose group, with statistically significant differences (P<0.05). SDANN, SDNN, and RMSSD in both groups were higher than before treatment, and those in the high-dose group were higher than in the low-dose group, with statistically significant differences (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the high-dose group and the low-dose group (P>0.05). 【Conclusion】 High-dose metoprolol tartrate can better improve cardiac function, heart rate, blood pressure, and heart rate variability indicators in elderly patients with hypertension and heart failure. Its efficacy is superior to that of low-dose, with good safety, and it is worthy of clinical promotion and application.
|
|
Received: 28 September 2025
|
|
|
|
|
|
[1] 赵晓晓,卢笑晖,柯立鑫,等. 1990—2021年全球与中国老年人群高血压疾病负担分析及未来趋势预测[J].协和医学杂志,2025,16(3):647-658. [2] DI PALO K E, BARONE N J. Hypertension and heart failure: prevention, targets, and treatment[J].Heart Fail Clin,2020, 16(1):99-106. [3] 李慧婷,屈丽娜,张泽武,等. 美托洛尔联合厄贝沙坦治疗高血压合并心力衰竭的临床疗效分析[J].疑难病杂志,2025,24(6):646-650. [4] 马明,李嫣红,吉锋,等.沙库巴曲缬沙坦联合小剂量美托洛尔治疗中青年高血压的临床观察[J].现代生物医学进展, 2021, 21(1):193-196. [5] 中国高血压防治指南修订委员会,高血压联盟(中国),中国医疗保健国际交流促进会高血压分会,等. 中国高血压防治指南(2024年修订版)[J].中华高血压杂志,2024,32(7):603-700. [6] 中华医学会心血管病学分会,中国医师协会心血管内科医师分会,中国医师协会心力衰竭专业委员会,等. 中国心力衰竭诊断和治疗指南2024[J].中华心血管病杂志,2024,52(3):235-275. [7] HERMIDA R C, CRESPO J J, DOMÍNGUEZ-SARDIÑA M, et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial[J].Eur Heart J,2020,41(48):4565-4576. [8] 殷宇岗,吕磊,汪文妮.原发性高血压合并心力衰竭患者血清神经调节蛋白-1与心室重塑的相关性分析[J].中国现代医学杂志,2022,32(2):58-63. [9] 顾烽,符霞,孙立勤,等.厄贝沙坦联合硝普钠治疗高血压合并心力衰竭的效果及对血清cTnI和BNP水平的影响[J].广东医学,2020,41(9):929-932. [10] 时彬,卢运,魏晶晶.酒石酸美托洛尔联合贝那普利对高血压合并心力衰竭患者心功能指标、血压昼夜节律变化及心率变异性的影响[J].中南医学科学杂志,2022,50(1):93-97. [11] 李艳娜,薛雯雯,赵梦瑜.乌拉地尔与酒石酸美托洛尔治疗高血压合并心力衰竭的临床疗效观察[J].中国临床医生杂志,2020,48(6):659-662. [12] 谢勇,徐祖余,胡海强,等. 沙库巴曲缬沙坦联合酒石酸美托洛尔治疗高血压伴心力衰竭的疗效及其对血压及心功能指标的影响[J].检验医学与临床,2025,22(5):695-698. [13] 卢婧,王晓静,谭海龙,等. 参芍片联合酒石酸美托洛尔片对冠心病心绞痛患者氧化应激、血管内皮功能和心肌损伤标志物的影响[J].现代生物医学进展,2022,22(20):3882-3886. [14] 陈豫贤,于淑君,肜云鹏. 沙库巴曲缬沙坦钠联合酒石酸美托洛尔对老年慢性心力衰竭患者心脏重构及心功能的影响[J].医药论坛杂志,2021,42(18):132-135. [15] 侯亚玲,秦娜娜,李保银,等. 酒石酸美托洛尔对患者主动脉瓣置换术围手术期心率变异性的影响[J].实用药物与临床,2024,27(11):829-832. |
|
|
|