Effects of enalapril folic acid combined with levamlodipine on incidence of cardiovascular and cerebrovascular events in patients with essential hypertension

Abstract

Essential hypertension (EP) is a chronic disease. Effective treatment of hypertension is one of most crucial preventions of cardiovascular (CV) and cerebrovascular (CBV) events. Enalapril folic acid combined with levamlodipine is an effective therapy to treat EP, but its effect on CV and CBV events in hypertensive patients is unknown. This study set out to assess the effects of enalapril folic acid combined with levamlodipine on incidence of CV and CBV events in patients with EP. We randomly assigned 172 patients with EP enrolled in our hospital between April 2017 and September 2018 to receive Levoamlodipine Maleate Dispersible Tablets alone (the control group, n = 85) or Levoamlodipine Maleate Dispersible Tablets combined with Enalapril Maleate and Folic Acid Tablets (the combination group, n = 87). All patients received basic treatment. After 4 weeks of treatment, we recorded the clinical outcomes and adverse reactions of all patients and compared the blood pressure before and after the treatment. The CV and CBV events happening in the two groups within 3 months after the treatment were also recorded. After 4 weeks of treatment, in contrast to the control group, the combination group had a higher marked response rate and lower moderate response rate and non-response rate (P <0.05). The two groups displayed no great disparity in complication rate (P >0.05). Before treatment, the two groups did not differ in pulse pressure (PP), diastolic blood pressure (DBP), and systolic blood pressure (SBP) (P >0.05). After 4 weeks of treatment, both groups showed decreased PP, DBP, and SBP (P <0.05), with lower PP, DBP, and SBP in the combination group (P <0.05). The main CV and CBC events happening in the two groups during the 3-month follow-up included heart failure, stroke, unstable angina pectoris, transient cerebral hemorrhage, acute coronary syndrome, and accelerated heart rate, devoid of fatality. The control group obtained 22 cases (25.88%) of CV and CBC events, which was remarkably higher than the combination group that had 8 cases (9.20%) (P <0.05). In conclusion, the enalapril folic acid combined with levamlodipine therapy is clinically valuable since it can better control blood pressure and reduce the incidence of CV and CBC events in patients without increasing the risk of adverse reactions.