动态血压监测苯磺酸左旋氨氯地平治疗轻、中度高血压疗效观察

目的 应用动态血压监测评估苯磺酸左旋氨氯地平对轻、中度高血压降压效果.方法 选择42例轻、中度原发性高血压患者,观察苯磺酸左旋氨氯地平治疗前后的诊所偶测血压、动态血压、白昼和夜间的血压负荷及降压谷峰比率.结果 苯磺酸左旋氨氯地平治疗后偶测血压、动态血压均明显降低(P<0.05或P<0.01),降压疗效总有效率为90.5%.结论 对轻度高血压患者苯磺酸左旋氨氯地平能达到24 h全程平稳降血压,是符合时间诊疗学原理的理想降压药物.     

苯璜酸左旋氨氯地平对高血压患者颈动脉内膜-中膜厚度影响的临床研究

目的 观察苯磺酸左旋氨氯地平对原发性高血压患者颈动脉内膜-中膜厚度(IMT)的影响.方法 选取2007年1月-2008年1月我院120例1～2级原发性高血压患者,随机分为两组,每组各60例,治疗组给予苯磺酸左旋氨氯地平片治疗,对照组给予硝苯地平控释片治疗.所有患者随访2年,对患者治疗前后的血压及颈动脉IMT进行观察比较.结果 治疗组患者治疗前后血压水平及颈动脉IMT分别与对照组比较,差异均无统计学意义(P＞0.05);两组患者血压水平及颈动脉IMT治疗前后比较,差异均有统计学意义(P＜0.05).结论 苯磺酸左旋氨氯地平可有效逆转高血压患者颈动脉IMT.     

凌晨血压增高与亚临床动脉粥样硬化密切相关

目的 探讨高血压患者凌晨血压增高(MBPS)及动态血压监测参数与颈动脉粥样硬化的关系.方法 高血压患者226例,分为MBPS组(51例)与非MBPS组(175例),并根据颈动脉内膜中膜厚度(IMT)分为IMT增厚组94例和非IMT增厚组132例,分别检查血脂、动态血压监测、颈动脉超声等,比较两组之间年龄、动态血压参数以及颈动脉IMT以及斑块Crouse积分的差别.结果 1)MBPS组MBPS值、凌晨平均动脉压、凌晨脉压、颈动脉IMT、斑块积分显著高于非MBPS组(P＜0.05);2)颈动脉IMT增厚组MBPS值、凌晨平均动脉压、凌晨脉压、24 h平均收缩压、24 h平均舒张压、白昼平均收缩压、白昼平均舒张压、夜间平均收缩压、夜间平均舒张压显著高于颈动脉非IMT增厚组(P＜0.05).结论 MBPS者颈动脉粥样硬化程度较高,MBPS可能促进颈动脉粥样硬化进程.     

氨氯地平合用阿托伐他汀钙对高血压颈动脉及血管内皮功能的影响

动脉内-中膜厚度(IMT)是反映动脉硬化的敏感特异性指标,颈总动脉IMT能够独立预测心脑血管病事件,还可用于评价各种治疗方法对动脉硬化的逆转或消退作用[1].研究表明,苯磺酸左旋氨氯地平能逆转颈动脉IMI[2],他汀类能显著降低冠心病死亡率,已广泛用于防治动脉粥样硬化疾病.两者合用对颈动脉IMT及血管内皮功能的影响还少见报道.本研究观察苯磺酸左旋氨氯地平合用阿托伐他汀钙的降压作用及对高血压患者颈动脉IMT及血管内皮功能的影响.     

凌晨血压增高与亚临床动脉粥样硬化密切相关

目的探讨高血压患者凌晨血压增高(MBPS)及动态血压监测参数与颈动脉粥样硬化的关系。方法高血压患者226例,分为MBPS组(51例)与非MBPS组(175例),并根据颈动脉内膜中膜厚度(IMT)分为IMT增厚组94例和非IMT增厚组132例,分别检查血脂、动态血压监测、颈动脉超声等,比较两组之间年龄、动态血压参数以及颈动脉IMT以及斑块Crouse积分的差别。结果1)MBPS组MBPS值、凌晨平均动脉压、凌晨脉压、颈动脉IMT、斑块积分显著高于非MBPS组(P<0.05);2)颈动脉IMT增厚组MBPS值、凌晨平均动脉压、凌晨脉压、24h平均收缩压、24h平均舒张压、白昼平均收缩压、白昼平均舒张压、夜间平均收缩压、夜间平均舒张压显著高于颈动脉非IMT增厚组(P<0.05)。结论MBPS者颈动脉粥样硬化程度较高,MBPS可能促进颈动脉粥样硬化进程。     

36例苯磺酸左旋氨氯地平治疗高血压临床疗效观察

本文研究通过血压动态监测法观察患者服用苯磺酸左旋氨氯地平以及硝苯地平缓释片疗效以及持续作用时间。随机选自我院在2012年1月至2015年10月收治的符合条件的轻中度高血压患者36例年龄(男性58.3士1.2岁,女性56.2士1.1岁),每组18例患者,每天服用苯磺酸左旋氨氯地平和硝苯地平缓释片,治疗前后分别监测动态血压。结果以周治疗为单位,对患者的血压变化下降幅度进行观察收缩压和舒张压变化,苯磺酸左旋氨氯地平治疗原发性高血压血压明显下降、血压负荷值明显减小(P0.01),心率变化不明显(P0.05)。结论苯磺酸左旋氨氯地平治疗原发性高血压见效快,安全性高,稳定性好,可将其作为治疗原发性高血压的首选药物。     

左旋氨氯地平对原发性高血压患者颈动脉内-中膜厚度的逆转作用

目的:探讨左旋氨氯地平对原发性高血压患者颈动脉内-中膜厚度(IMT)的影响。方法:将76例原发性高血压患者随机分为试验组和对照组,对照组常规使用利尿剂和卡托普利治疗,试验组在对照组基础上加用左旋氨氯地平2.5mg,qd,均治疗8周,比较2组颈动脉IMT、血压、心率、空腹血糖及TG、TC、HDL-C和LDL-C的变化。结果:试验组颈动脉IMT、收缩压及舒张压水平均显著降低,与治疗前及对照组比较均差异有统计学意义(均P<0.05)。血脂各指标、血糖、心率2组间均差异无统计学意义。结论:左旋氨氯地平具有良好的降压作用,同时对原发性高血压患者颈动脉IMT增加具有逆转作用。     

氨氯地平联合阿托伐他汀钙对高血压颈动脉内膜中层厚度的影响

目的研究苯磺酸左旋氨氯地平联合应用阿托伐他汀钙对高血压患者颈动脉内膜中层厚度(IMT)的影响。方法将原发性高血压患者168例,随机分为实验组(84例)和对照组(84例),对照组使用苯磺酸左旋氨氯地平2.5mg,1次/d,2周后,血压未降至140/90mmHg(1mmHg=0.133kPa)以下者,增加剂量至5mg(2.5mg/次,2次/d),实验组在对照组基础上,加用阿托伐他汀钙10mg,1次/晚,治疗12个月,比较两组IMT、血压、空服血糖及血脂水平。结果实验组治疗12个月后,颈动脉IMT、收缩压、舒张压、TG、TC、LDL-C均显著降低,治疗后的IMT(0.76±0.07)mm,与治疗前(0.95±0.07)mm及对照组治疗前后的(0.97±0.05)mm、(0.84±0.06)mm比较,差异均有统计学意义(P<0.05)。两组间血糖、心率比较差异无统计学意义。结论高血压患者苯磺酸左旋氨氯地平联合阿托伐他汀钙治疗能更好的延缓颈动脉IMT进展。     

苯磺酸左旋氨氯地平联合贝那普利治疗原发性高血压的疗效

目的探讨苯磺酸左旋氨氯地平(施慧达)联合贝那普利对原发性高血压(高血压)的疗效。方法选取2009年12月至2011年12月经余杭医院确诊的高血压患者320例,采用整群随机分组法分为苯磺酸左旋氨氯地平加贝那普利组和苯磺酸左旋氨氯地平组各160例,比较两组的疗效。结果苯磺酸左旋氨氯地平加贝那普利组总有效率显著高于苯磺酸左旋氨氯地平组,差异有统计学意义(93.8%vs.80.0%,P<0.05)。两组治疗组后血压均比治疗前下降,但苯磺酸左旋氨氯地平加贝那普利组收缩压下降优于苯磺酸左旋氨氯地平组,差异有统计学意义[(133.6±9.6)mm Hg vs.(144.7±12.8)mm Hg,P<0.01,1 mm Hg=0.133 kPa]。结论苯磺酸左旋氨氯地平联合贝那普利对高血压降压效果明显,且副作用少,是治疗高血压的理想方案。     

马来酸左旋氨氯地平与苯磺酸左旋氨氯地平治疗老年高血压的疗效对比

目的比较马来酸左旋氨氯地平与苯磺酸左旋氨氯地平治疗老年高血压的效果。方法将我院门诊确诊的60例原发性老年高血压患者随机分为马来酸左旋氨氯地平组和苯磺酸左旋氨氯地平组,各30例,马来酸左旋氨氯地平组给予马来酸左旋氨氯地平2.5mg,苯磺酸左旋氨氯地平组给予苯磺酸左旋氨氯地平2.5mg,随访4周,观察两组清晨血压降幅、疗效及不良反应。结果马来酸左旋氨氯地平组清晨血压平均降幅均高于苯磺酸左旋氨氯地平组,差异有统计学意义(P<0.05);两组患者疗效比较,差异无统计学意义(P<0.05);两组患者治疗期间均未出现明显不良反应。结论马来酸左旋氨氯地平和苯磺酸左旋氨氯地平均能起到降压的作用,但马来酸左旋氨氯地平较苯磺酸左旋氨氯地平对于清晨血压的控制表现出明显的优势。     

Significance of mean blood pressure for blood pressure control

The significance of pulse pressure (PP) and mean blood pressure (MBP) for blood pressure (BP) control is unclear. The aim of this study was to examine the relationship between PP and MBP and BP control. We obtained home BP measurements for 117 patients aged 40-75 years with either office systolic BP (SBP) >or= 140 mmHg or office diastolic BP (DBP) >or= 90 mmHg. Patients were treated with 1 to 2 antihypertensive drugs for 6 months to achieve home SBP < 135 mmHg and home DBP < 85 mmHg. At follow-up, 72 patients were taking a single drug with good BP control, 23 were taking two drugs with good BP control, and 22 were taking two drugs without good BP control. Although office SBP and DBP at baseline were similar in the three groups, home SBP and DBP at baseline in the single drug group were lowest among the three groups (P < 0.01). Home MBP at baseline in the single drug group was lowest among the three groups (P < 0.01). Home PP at baseline was highest in the two-drug without good control group (P < 0.001). In multivariate logistic regression analysis, only home MBP at baseline was significantly correlated with a lack of BP control. Home MBP rather than home PP is associated with achieving adequate BP control.     

Low blood pressure

When facing a chronic hypotension, underlying chronic diseases must be ruled out. In most cases, it concerns a "constitutional" benign, low blood pressure, however ill-tolerated and associated with neurovegetative dystonia. In so far as it is not a disease, there is no specific treatment. The long-term prognosis is excellent since symptoms usually improve with years and a low blood pressure is a sign of longevity.     

Wrist blood pressure overestimates blood pressure measured at the upper arm

OBJECTIVE: Whether blood pressure (BP) measured at the wrist differs from blood pressure measured at the arm is not well known. The aim of this study was to compare the BP readings obtained at the arm with those obtained at the forearm and to assess whether the wrist-arm discrepancies were related to subjects' clinical characteristics. METHODS: We measured blood pressure at the forearm and at the upper arm in 85 subjects using conventional sphygmomanometry. Wrist-arm blood pressure discrepancies were assessed in relation to gender, age, body mass index, skin-fold thickness, arm size, blood pressure level, and arterial compliance measured with the HDI/Pulsewave CR-2000. RESULTS: Blood pressure measured at the wrist consistently overestimated blood pressure taken at the arm with a mean (+/-SD) discrepancy of 8.2 +/- 9.7/9.2 +/- 6.4 mmHg. The systolic blood pressure differences were greater in men than in women (p=0.006) and, among the men, varied according to arm adiposity (positive association, p=0.01). In men, diastolic blood pressure differences correlated with diastolic blood pressure level (negative association, p=0.01). Among the women, only age (p=0.04) was a significant positive independent predictor of the wrist-arm diastolic BP differences. CONCLUSIONS: These results indicate that forearm blood pressure measurement markedly overestimates upper arm blood pressure and that the between-site difference may vary from subject to subject. Wrist blood pressure measurement is not a valid alternative to traditional measurement at the arm and its use should be discouraged.