苯那普利对高血压病患者心率变异性及其昼夜节律的影响

目的　观察苯那普利对高血压病患者动态血压、心率变异性及其心率变异性昼夜节律的影响。方法　 3 6例高血压病人 ,服用苯那普利 ( 10～ 2 0 mg/ d) 8周 ,用药前后做动态血压和 2 4h动态心电图分析。结果　治疗后动态血压各指标均下降 ( P<0 .0 5或 <0 .0 1) ;HRV(心率变异性 )时域指标 RMSSD(全部相邻 RR间期之差的均方根值 )升高 ( P<0 .0 5 ) ,其他指标虽均有升高 ,但无统计学意义 ( P>0 .0 5 ) ;频域指标中 HF(高频功率 )增加 ,L F(低频功率 )、L F/ HF下降 ;5分钟 HRV中治疗后白昼段和夜间段 HF均升高 ,L F/ HF均下降 ,且白昼段 L F较夜间段高 ,HF比夜间段低。结论　苯那普利可以很好控制全天血压 ,同时降低交感神经活性 ,提高迷走神经张力 ,且不干扰心率变异性的昼夜节律

Influence of benazepril on heart rate variability and its circadian rhythm in patients with hypertension

Objective To observe the effects of benazepril on the ambulatory blood pressure , heart rate variability (HRV) and its circadian rhythm in the patients with primary hypertension. Methods 36 cases with essential hypertension take benazepril 10~20mg/d for 8 weeks . The blood pressure were measured with ambulatory blood pressure monitoring (ABPM) and the heart rate variability, its rhythm with ambulatory electrocardiography before and after treatment. Results All SBP and DBP of ABPM after treatment were significantly lower than that before treatment. RMSSD was increased ( P <0.05). HF was increased, LF and the ratio of LF to HF were remarkly decreased. About 5 minute HRV, HF and LF/HF were increased during day stage and night stage after treatment, and LF during day stage was higher than that during night stage, and HF during day stage was lower than that during night stage. Conclusion Benazepril can control the 24h blood pressure, decrease the sympathetic nerve system and increase the vagus nerve activity with the reservation of the circadian rhythm of HRV.