降壓藥替米沙坦 減少乾咳副作用Dry cough relief drug side effects reduce the telmisartan

降壓藥替米沙坦 減少乾咳副作用 【施靜茹】糖尿病腎病變合併有高血壓的患者，常以ACEI類降壓藥控制病情，但有患者會產生嚴重乾咳及高血鉀等副作用而停藥，一項最新臨床試驗顯示，ARB類降壓藥替米沙坦（telmisartan ）能減低這些副作用。 74歲的謝女士罹患第二型糖尿病十多年，後來得注射胰島素並且洗腎，由於她合併有高血壓，每次洗完腎，還是得撐著虛弱的身子，再服用降血壓藥及降血脂藥。 成功大學醫學院附設醫院院長陳志鴻表示，台灣有六成糖尿病患像謝女士一樣，合併有高血壓問題，由於一般降壓藥會影響血糖及血脂變化，美國糖尿病醫學會建議，糖尿病腎病變患者，可以ACEI類（血管張力素轉化酉每抑制劑）或ARB類（血管張力素第二型受體拮抗劑）降壓藥，來延緩腎臟惡化。 日前在中國北京舉行的第19屆長城國際心臟病學會議，中國醫學科學院阜外心血管病醫院教授劉力生發表一項「ONTARGET」研究，收集全球2萬5000名心血管患者。 劉力生表示，全球約有10%至39%患者對ACEI類降壓藥雷米普利（Ramipril）不耐受，因產生嚴重乾咳、高血鉀及血管神經性水腫副作用而停藥。 「ONTARGET」研究發現，亞洲患者每天服用替米沙坦80毫克，和每天服用雷米普利10毫克的療效相當，且前者耐受性較佳，在亞洲患者尤為明顯，前者服用後因副作用停藥者為14.4%，後者因副作用停藥為19.9% 。 台灣嘉義基督教醫院心臟內科主任陳澄鋆指出，糖尿病腎病變患者，黃金治療準則多為服用雷米普利，這項研究顯示，糖尿病腎病變患者有另一種副作用更低的降壓藥可選擇。 高雄長庚醫院內科臨床教授傅懋洋指出，替米沙坦比起一般ARB類降壓藥，能有較長約廿四小時的作用，這對心血管患者常在清晨發作來說，較有保護力。 也是世界高血壓聯盟主席劉力生，負責編寫2005年的「中國高血壓防治指南」，她表示，中國不久應會修訂高血血治療準則，也會將藥物考量進去。 2008-10-30 Dry cough relief drug side effects reduce the telmisartan Shi Jing-Ru】 【diabetic kidney disease associated with high blood pressure patients, often with ACEI-type drugs to control blood pressure condition, but patients will have serious cough and hyperkalemia, such as drug side effects, a new clinical trial showed that, ARB class of antihypertensive Drug telmisartan (telmisartan) can reduce these side effects. Miss Xie, 74-year-old suffering from type II diabetes for more than a decade later was injected insulin and dialysis, because of the merger, she has high blood pressure, kidney-per-washing, or too weak pluggin body, and then to take blood pressure lowering drugs and medicine . Kung University Medical College Hospital president Jyh-Hong Chen said that Taiwan has 60 percent of diabetes patients as Miss Xie, problems associated with high blood pressure, blood pressure medicine because of the general will affect the blood glucose and blood lipid changes in the American Diabetes Association recommends that diabetic patients with kidney disease, Class ACEI (Angiotensin-converting enzyme inhibitors) or type of ARB (Angiotensin II receptor antagonist) antihypertensive drugs to slow the deterioration of the kidney. A few days ago in Beijing, China Great Wall of the 19th international cardiology meeting, Chinese Academy of Medical Sciences Fuwai Cardiovascular Disease Hospital, Professor Liu Lisheng issued a "ONTARGET", a global collection of 25,000 cardiovascular patients. Liu Li-sheng said that about 10-39 percent of patients with blood pressure medicine category ACEI ramipril (Ramipril) is not tolerated, as a result of severe dry cough, hyperkalemia and vascular edema and drug side-effects. "ONTARGET" The study found that Asian patients taking telmisartan 80 mg per day, and taking ramipril 10 mg per day of considerable effect, and the former is better tolerated, especially in patients in Asia, after taking the former as a result of Drug side-effects were 14.4% and the latter as a result of drug side effects for 19.9 percent. Taiwan's Chiayi Christian Hospital medical director of the cardiac Jun Chen Cheng pointed out that diabetic patients with kidney disease, the guidelines for the treatment of multiple for gold to take ramipril, the study showed that patients with diabetic nephropathy have another side effect of lower blood pressure drugs can choose. Kaohsiung Chang Gung Memorial Hospital clinical professor of internal medicine Fu Yang pointed out that the ARB telmisartan compared with the general class of antihypertensive drugs, to have about 24 hours longer, often in patients with cardiovascular This is in the early morning attack, the more force protection. World Hypertension League is also the Chairman of the Li-Sheng Liu, in charge of the preparation of the 2005 "China's prevention and treatment guidelines for high blood pressure," she said, China will soon be amended guidelines for the treatment of high blood blood, the drug will also get consideration. 2008-10-30 View more information, see the World Journal reported that e-ePaper

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