氨氯地平和依那普利对高血压患者清晨血压的影响观察

目的：比较苯磺酸氨氯地平和马来酸依那普利以及两药联合应用三种治疗方案对清晨高血压的控制效果。方法对入选的230例老年高血压患者行24 h动态血压监测，根据监测结果筛选出清晨高血压患者135例，入选患者停用抗高血压药物14 d，随机分为3组，其中服用苯磺酸氨氯地平的46例患者为组1，服用马来酸依那普利的41例患者为组2，联合服用苯磺酸氨氯地平和马来酸依那普利的48例患者为组3，观察4周清晨血压（家庭自测血压），比较3组患者清晨血压控制情况。结果三种治疗方案均能明显降低收缩压和舒张压（P<0.01），但组1和组3的平均血压下降幅度明显大于组2（P<0.05），且组3的降压达标率高于组1。结论苯磺酸氨氯地平和马来酸依那普利均为比较安全和有效的长效抗高血压药物，但在清晨血压的控制方面，苯磺酸氨氯地平明显优于马来酸依那普利，而联合应用两药的治疗方案可提高清晨血压的控制达标率。

Efficacy of morning hypertension using besylate Amlodipine and Enalapril maleate

Objective To compare the the controlling results of early morning hypertension by amlodipine besylate and enalapril maleate.Methods According to the results of 24 h ambulatory blood pressure monitoring, 135 morning hypertensive patients were screened out from 230 elderly hypertensive patients. And antihypertensive medications originally were abandoned for 14 days. The patients were divided into three groups randomly. And 46 patients were asked to take amlodipine besylate as the group1,41 patients were asked to take enalapril maleate as the group2,while the other 48 patients were asked to take amlodipine besylate and enalapril maleate as group3.The morning blood pressure for four weeks(home self-test blood pressure) were observed to understand the controlling results of early morning hypertension.Results Three treatment programs can significantly lower the blood pressure(P<0.01),however, the group1 and group3 was significantly lower than that of the group2 (P<0.05).And group 3 is higher compliance rate than group 1.Conclusion Amlodipine besylate and enalapril maleate are both relatively safe and effective long-acting antihypertensive drugs. The study showed that amlodipine besylate is better than enalapril maleate on the controlling of morning blood pressure surge. The two drugs in combination regimens can improve the compliance rate of morning hypertension and effectively control the hypertension in morning.