不同服药时间对老年高血压患者降压效果的影响

[目的]探讨不同时间服用长效钙拮抗剂左旋氨氯地平对老年高血压患者降压效果的影响.[方法]选取108例2级以上原发性高血压患者,随机分为左旋氨氯地平早晨服药组（A组）和晚间服药组（B组）,药物治疗前后分别进行诊室血压和动态血压监测的检查.[结果]①两组患者的诊室收缩压（SBP）和舒张压（DBP）均明显降低（P〈0.05）,两组之间诊室血压下降差值的比较差异无统计学意义（P〉0.05）.②动态血压监测结果显示早晨服药和晚间服药均能降低24 h平均收缩压（24hSBP）、24 h平均舒张压（24hDBP）、白昼平均收缩压（dSBP）、白昼舒张压（dDBP）、夜间平均收缩压（nSBP）和夜间舒张压（nDBP）,差异有统计学意义（P〈0.05）.③晚间服药组患者24hSBP和nSBP明显低于早晨服药组患者（P〈0.05）.[结论]早晨或晚间服用长效钙拮抗剂均能有效降低老年高血压患者的血压值,晚间服药组患者能更有效的降低夜间血压.

Impact of antihypertensive medication timing on degree of blood pressure lowering in patients with essential hypertension

[Objective] To investigate the impact of antihypertensive medication timing on degree of blood pressure（BP） lowering in patients with moderate and severe essential hypertension. [Methods]one hundred and eight elderly patients were treated with amlodipine （Smg/d）with morning dose （ n = 54）and evening dose pro- gram（ n =54） for 2 weeks. [Results] （1）both programs decreased office SBP with no differences between them（ P 〉0.05）. （2） ABPM showed that both programs effectively decreased 24hSBP, 24hDBP, dSBP, dDBP, nSBP and nDBP（ P 〉0.05）. （3） 24hSBP and night-time SBP by evening program are greatly lower than that by morning program（ P〈0.05）. [Conclusion]Both morning and evening programs of levo-amlodipine administration were effective in decreasing BP. Compared with morning program, evening program might be more effective in decreasing the high night BP load.