Objective To investigate the efficacy of various calcium channel blockers combined with folic acid in the treatment of elderly patients with mild to moderate high homocysteine (Hcy) hypertension (H type hypertension). Methods A randomized, single-blind, parallel-controlled trial was carried out on 90 elderly in- and out-patients with mild to moderate primary H type hypertension of grades 1 to 2 in our department from June 2011 to June 2014. They were 42 males and 48 females, and at an age of (66.9±3.5) years. They were randomly assigned into 3 groups (n=30): group 1 (5mg/d amlodipine), group 2 (2.5mg/d levamlodipine) and group 3 (5mg/d felodipine), all combined with folic acid (0.8mg/d). Blood pressure and serum levels of Hcy, nitric oxide (NO), endothelin-1 (ET-1), superoxide dismutase (SOD) and malondialdehyde (MDA) were measured before and after 4 weeks’ treatment. Results Blood pressure and serum Hcy level were significantly decreased in all 3 groups. Compared to the other 2 groups, amlodipine combined with folic acid had significant effectiveness in lowing both systolic blood pressure and serum Hcy level (P<0.05). In amlodipine group, the serum levels of NO and SOD were significantly increased, and those of ET-1 and MDA were significantly decreased after treatment (P<0.05). Conclusion Calcium channel blockers combined with folic acid can reduce both blood pressure and plasma Hcy level in the elderly patients with mild to moderate H type hypertension. The therapeutic scheme of amlodipine combined with folic acid is the best option.%目的：评价不同钙通道阻滞剂联合叶酸对老年轻中度高同型半胱氨酸（Hey，H型）高血压患者的疗效。方法采用随机、单盲、平行对照方法，纳入2011年6月至2014月6月在河北省沧州中西医结合医院心血管病科门诊或住院治疗的原发性H型高血压Ⅰ～Ⅱ级患者90例，其中男42例，女48例，年龄（66.9±3.5）岁。将入选患者随机分为苯磺酸氨氯地平组，苯磺酸左氨氯地平组和非洛地平缓释片组，每组30例，均联合叶酸连续口服药物4周。按时监测血压，并予试验开始前、治疗4周时进行血浆Hcy、一氧化氮（NO）、内皮素−1（ET-1）、超氧化物歧化酶（SOD）、丙二醛（MDA）测定。结果3种钙通道阻滞剂联合叶酸均可降低老年轻中度H型高血压患者的血压和血浆Hcy水平，且苯磺酸氨氯地平组降低收缩压的幅度和血浆Hcy水平大于其他两组，差异具有统计学意义（P＜0.05）。苯磺酸氨氯地平组，治疗后较治疗前血浆NO和SOD水平升高，ET-1和MDA水平降低，差异具有统计学意义（P＜0.05）。结论钙通道阻滞剂联合叶酸可用于降低老年轻中度H型高血压患者的血压和血浆Hcy水平，且以苯磺酸氨氯地平联合叶酸为优。
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