苯磺酸氨氯地平联合替米沙坦应用对老年原发性高血压患者血压晨峰和血压变异性的影响

目的：探讨苯磺酸氨氯地平联合替米沙坦对老年原发性高血压患者血压晨峰及血压变异性的影响.方法：选择2011年3月-2012年3月齐齐哈尔市第一医院收治的老年原发性高血压患者48例,给予苯磺酸氨氯地平（5mg/d）联合替米沙坦（40mg/d）治疗4周.治疗前后分别进行24 h动态血压监测,采用自身对照研究的方法对比分析治疗前后患者血压晨峰及血压变异性的差异.结果：与治疗前比较,老年原发性高血压患者治疗后的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、血压晨峰、24 h收缩压标准差、24 h舒张压标准差、24 h收缩压变异系数、24 h舒张压变异系数均下降,治疗前后比较差异均有统计学意义（P＜0.05）.治疗后的总胆固醇、低密度脂蛋白胆固醇较治疗前下降,治疗前后比较差异均有统计学意义（P＜0.01）.结论：氨氯地平联合替米沙坦降压治疗可有效降低老年高血压患者的血压晨峰及血压变异性.     

Comparing differences and correlation between 24-hour ambulatory blood pressure and office blood pressure monitoring in patients with untreated hypertension

ObjectiveWe assessed differences and correlations between 24-hour ambulatory blood pressure (ABP) and office blood pressure (OBP) monitoring.MethodsWe conducted an observational study among 85 untreated patients with essential hypertension and measured 24-hour ABP, OBP, target organ damage (TOD) markers, and metabolism indexes. Variance analysis and the Pearson method were used to compare differences and correlation between the two methods. The Spearman or Pearson method was applied to compare the correlation between TOD markers, blood pressure index, and metabolism index. Linear regression analysis was applied to estimate the quantitative relationship between the blood pressure index and TOD markers.ResultsThere were significant differences in the mean and variance of systolic blood pressure (SBP) and diastolic blood pressure and a positive correlation between ABP and OBP. Correlations between the left ventricular mass index (LVMI) and average ambulatory SBP, daytime ambulatory SBP, nighttime ambulatory SBP, and fasting blood glucose were significant. Correlations between left intima-media thickness (IMT) and average ambulatory SBP, nighttime ambulatory SBP, right IMT, and nighttime ambulatory SBP were significant. In linear regression analysis of the LVMI (y) and ambulatory SBP (x), the equation was expressed as y = 0.637*x.ConclusionNighttime ambulatory SBP may be an optimal predictor of TOD.     

高血压合并冠心病患者血压变异性及动态血压的变化

[目的]分析高血压合并冠心痛患者的血压变异性与动态血压变化特点.[方法]选取2014年6月至2015年6月本院收治的160例高血压患者的临床资料.根据冠脉造影(CGA)结果或冠脉CT成像(CTA)诊断结果将其分为冠心病合并高血压组(n=80,观察组),单纯性高血压组(n=80,对照组),对两组患者动态血压和血压变异性指标进行分析比较.[结果]观察组患者日间平均收缩压、夜间平均收缩压、24h平均收缩压、日间平均脉压、夜间平均脉压、24h平均脉压、日间平均收缩压标准差、夜间平均收缩压标准差、24h平均收缩压标准差均显著高于对照组,差异有统计学意义(均P＜0.05);观察组与对照组患者在日间平均舒张压、夜间平均舒张压、24h平均舒张压、日间平均舒张压标准差、夜间平均舒张压标准差、24h平均舒张压标准差方面比较,差异均无统计学意义(均P＞0.05).[结论]高血压合并冠心病患者其动态血压波动比较大,且血压变异性相对增大,加强其血压动态血压与血压变异性监测对冠心病合并高血压的临床诊治有着一定的作用.     

高血压患者血压昼夜节律变化的临床意义

目的:探讨高血压患者血压昼夜均值波动的节律与临床意义。方法:对112例高血压患者根据超声心动图(ultra-sonic cardiography,UCG)检查结果分成3组,其中UCG显示左室肥大30例,均伴单纯收缩压升高(isolated systolic hyperten-sion,ISH)或收缩压和舒张压均升高(miscellaneous systolic and diastolic hypertension,MDH),平均年龄(58±12.1)岁,为LVH组;UCG正常的ISH患者48例为ISH组,平均年龄(62±15.2)岁;UCG正常的MDH患者34例为MDH组,平均年龄(51±12.0)岁。另选健康体检者中动态血压监测(ambulatory blood pressure monitoring,ABPM)正常的30例为对照组,平均年龄(54±10.3)岁。获取4组研究对象的24 h平均收缩压(24-hour mean systolic blood pressure,24 hSBP)和舒张压(24-hourmean diastolic blood pressure,24 h DBP)、白昼平均收缩压(daytime mean systolic blood pressure,dSBP)和舒张压(daytimemean diastolic blood pressure,dDBP)、夜间平均收缩压(nighttime mean systolic blood pressure,nSBP)和舒张压(nighttimemean diastolic blood pressure,nDBP)、夜间/白昼平均收缩压比值(nSBP/dSBP)和舒张压比值(nDBP/dDBP)、收缩压负荷值与舒张压负荷值。结果:(1)正常组和ISH组血压均值波动都具有昼夜规律性,但其曲线有所不同;MDH组夜间血压下降幅度减小,LVH组昼夜规律不明显;(2)ISH组、MDH组与LVH组24 hSBP、dSBP、nSBP均高于对照组,而以ISH组及LVH组更为显著(P<0.001);(3)MDH组与LVH组nDBP/dDBP均显著高于对照组;(4)LVH组nSBP/dSBP比值及nDBP/dDBP比值显著高于对照组;(5)SBP负荷值LVH组大于MDH组,DBP负荷值LVH组小于MDH组。结论:高血病患者应积极随访动态血压监测,以观察血压升高的水平及昼夜节律的变化,并有针对性地进行干预,这对降低心脑血管疾病发生的风险有重要意义。     

肾实质性高血压患者动态血压变化的临床意义

目的:探讨肾实质性高血压患者动态血压昼夜变化的临床意义。方法:对50例临床诊断为肾实质性高血压患者的临床诊断进行分组:肾功能不全代偿期组20例;肾功能不全失代偿期组17例;肾功能衰竭期组13例;另选健康体检中动态血压监测正常者30例为对照组。获取4组对象白昼平均收缩压和舒张压、夜间平均收缩压和舒张压、24小时平均收缩压和舒张压、夜间/白昼平均收缩压和舒张压、平均动脉压及收缩压负荷值与舒张压负荷值。结果:(1)肾实质性高血压3组各项参数均高于对照组,昼夜曲线消失,但未见反勺型;(2)肾实质性高血压3组各项参数相互之间经方差检验有明显差别。尤其是收缩压与舒张压负荷值,在肾功能不全失代偿期组明显升高,在肾功能衰竭期组已超过60%。(3)肾实质性高血压各组之间收缩压负荷值、舒张压负荷值及平均动脉压存在显著差异。结论:肾实质性高血压患者血压昼夜节律消失,当肾功能失代偿时,血压负荷值及MAP随着肾功能的进一步恶化而升高。     

Melatonin production in hypertonic patients during magnetic storms

AIM: To study mechanisms of action of natural magnetic field of the Earth on arterial pressure (AP) and melatonin production in patients with essential hypertension (EH) stage II. MATERIAL AND METHODS: Clinical, laboratory and device investigations covered 52 men with EH stage II (mean age 42 +/- 0.92 years) and 11 healthy men (mean age 23 +/- 1.46 years). Mean 24-hour, mean daytime, mean night systolic and diastolic pressures, 24-h index, time hypertensive index, standard deviation were registered. Melatonin was measured in the urine by radioimmunoassay. Geomagnetic situation was assessed by K-index (quiet--under 15, disturbed--15-25, magnetic storm--above 25). RESULTS: In hypertensive patients AP grew with growth of geomagnetic activity. In normal subjects AP remained normal. The 24-h rhythm of AP variability in hypertensives was normal. Magnetic storm affected melatonin production in EH patients noticeably: night and daytime production of melatonin was low. In normal subjects night melatonin production was high. CONCLUSION: AH stage II patients respond to magnetic storm with maladaptation, i.e. a rise in AP and low melatonin production.     

Effects of a single bout of power exercise training on ambulatory blood pressure in older adults with hypertension: A randomized controlled crossover study

ObjectiveTo evaluate the effect of a single bout of power exercise training (PT) on office and ambulatory blood pressure (BP).MethodsTwenty-four older adults with essential hypertension participated in two experimental sessions in a randomized order: the PT composed of 3 sets of 8–10 repetitions in 5 power training exercises and the non-exercise control at seated rest (Con). Both experimental sessions lasted 40 min. Office BP was measured continuously for 1 h in the laboratory and 24 h BP through ambulatory blood pressure monitoring.ResultsCompared with Con, office systolic/diastolic BP decreased after PT (Systolic BP: 10 mmHg, p < 0.001; Diastolic BP: 4 mmHg, p = 0.015). A trend toward decrease (p = 0.06) was found in diastolic ambulatory BP during daytime (2 mmHg; p = 0.062) and nighttime (3 mmHg; p = 0.063) after PT. No differences were found between PT and Con sessions for systolic and mean ambulatory BP.ConclusionA single bout of PT decreases office BP but this hypotensive effect is not sustained under ambulatory conditions in older patients with essential hypertension.     

24-hour blood pressure control with ramipril: comparison of once-daily morning and evening administration

The antihypertensive efficacy of ramipril administered once daily, either in the morning or in the evening, was compared in an open, randomized, crossover trial in 33 patients with mild-to-moderate essential hypertension. A 24-hour ambulatory blood pressure monitoring device was used. A significant (P < 0.05) decrease from baseline blood pressure values was observed with both dosing regimens. A slight, but discernible difference in the effectiveness of the two regimens was observed in the mean daytime (10 am to 8 pm) blood pressure for both diastolic and systolic values. The mean daytime blood pressure decreased from 145.8/95.4 mm Hg to 139.7/89.7 mm Hg following morning administration and to 142.3/91.8 mm Hg following evening administration. The mean nighttime (midnight to 6 am) blood pressure was slightly lower in patients receiving ramipril in the evening than in those receiving the drug in the morning. The mean blood pressure during the critical time (4 am to 8 am) was similar for the two dosing regimens. Ramipril proved to be an efficacious antihypertensive treatment with once-daily dosing and provided as good, or slightly better, blood pressure control when administered in the morning than in the evening.     

针刺治疗对原发性高血压患者血压和心率变异性的影响

目的:探讨针刺治疗对原发性高血压患者血压变异性和心率变异性的影响。方法:选择符合条件的60例原发性高血压患者进行针刺治疗,疗程为30 d,采用自身前后对照,分别于治疗前后完善24 h动态血压及24 h动态心电图检查。结果:针刺治疗后血压变异性各指标(24 h平均收缩压、24 h平均舒张压、24 h收缩压标准差、24 h舒张压标准差、白昼收缩压标准差、白昼舒张压标准差、夜间收缩压标准差、夜间舒张压标准差)均较治疗前降低,差异具有统计学意义(P0.05);心率变异性各指标(连续RR间期标准差、平均5 min RR间期标准差、平均5 min RR间期标准差的平均值、连续RR间期差值的均方根值、相邻RR间期大于50ms的百分数)均较治疗前有所改善,差异具有统计学意义(P0.05)。结论:针刺治疗能显著降低原发性高血压患者的血压变异性,改善心率变异性,从而可能改善高血压患者的靶器官损害。     

高血压患者血压晨峰与冠状动脉病变相关性研究

目的探讨原发性高血压患者血压晨峰（morning blood pressure surge,MBPS）与冠状动脉病变的相关性。方法203例原发性高血压患者行冠状动脉造影术（coronary angiography,CAG）和24h动态血压（ambulatory blood pressure monitoring,ABPM）监测,根据ABPM有无MBPS现象分为晨峰组71例和非晨峰组132例,比较2组冠状动脉病变支数、病变Gensini总积分,分析冠状动脉病变的影响因素。结果晨峰组24h、白昼及夜间平均收缩压、冠状动脉病变发生率、3支病变发生率以及Gensini总积分均高于非晨峰组（P〈0.01）,而单支病变发生率低于非晨峰组（P〈0.01）;冠状动脉病变程度多元线性回归分析结果显示,年龄、24h收缩压及MBPS为冠状动脉病变的独立影响因素。结论 MBPS与冠状动脉病变程度有关,有效控制高血压患者的晨峰血压对减少靶器官损害有重要意义。     

Circadian blood pressure during the early course of type 1 diabetes. Analysis of 1,011 ambulatory blood pressure recordings in 354 adolescents and young adults.

OBJECTIVE: Little information is available on the early course of hypertension in type 1 diabetes. The aim of our study, therefore, was to document circadian blood pressure profiles in patients with a diabetes duration of up to 20 years and relate daytime and nighttime blood pressure to duration of diabetes, BMI, insulin therapy, and HbA1c. RESEARCH DESIGN AND METHODS: Ambulatory profiles of 24-h blood pressure were recorded in 354 pediatric patients with type 1 diabetes (age 14.6 +/- 4.2 years, duration of diabetes 5.6 +/- 5.0 years, follow-up for up to 9 years). A total of 1,011 profiles were available for analysis from patients not receiving antihypertensive medication. RESULTS: Although daytime mean systolic pressure was significantly elevated in diabetic subjects (+3.1 mmHg; P < 0.0001), daytime diastolic pressure was not different from from the height- and sex-adjusted normal range (+0.1 mmHg, NS). In contrast, both systolic and diastolic nighttime values were clearly elevated (+7.2 and +4.2 mmHg; P < 0.0001), and nocturnal dipping was reduced (P < 0.0001). Systolic blood pressure was related to overweight in all patients, while diastolic blood pressure was related to metabolic control in young adults. Blood pressure variability was significantly lower in girls compared with boys (P < 0.01). During follow-up, no increase of blood pressure was noted; however, diastolic nocturnal dipping decreased significantly (P < 0.03). Mean daytime blood pressure was significantly related to office blood pressure (r = +0.54 for systolic and r = +0.40 for diastolic pressure); however, hypertension was confirmed by ambulatory blood pressure measurement in only 32% of patients with elevated office blood pressure. CONCLUSIONS: During the early course of type 1 diabetes, daytime blood pressure is higher compared with that of healthy control subjects. The elevation of nocturnal values is even more pronounced and nocturnal dipping is reduced. The frequency of white-coat hypertension is high among adolescents with diabetes, and ambulatory blood pressure monitoring avoids unnecessary antihypertensive treatment.     

E-Tracking技术对高血压合并高脂血症患者颈动脉弹性及血压变异性的评估价值

目的探讨血管回声跟踪(E-Tracking)技术对高血压合并高脂血症患者颈动脉弹性及血压变异性(BPV)的评估价值。方法将本院收治的130例高血压患者根据是否合并高脂血症分为单纯高血压组(60例)和高血压合并高脂血症组(70例)。采用E-Tracking技术测定两组的颈动脉弹性参数,采用动态血压监测仪测定BPV系数,进一步采用Pearson检验判断颈动脉弹性参数与BPV系数的相关性。结果入院即刻,高血压合并高脂血症组的应变弹性系数(Eρ)、僵硬度(β)高于单纯高血压组,动脉顺应性(AC)低于单纯高血压组(P<0.05)。高血压合并高脂血症组的动态血压标准差[白天收缩压标准差(dSSD)、白天舒张压标准差(dDSD)、夜间收缩压标准差(nSSD)、夜间舒张压标准差(nDSD)]和动态血压变异系数[白天收缩压变异系数(dSCV)、白天舒张压变异系数(dDCV)、夜间收缩压变异系数(nSCV)、夜间舒张压变异系数(nDCV)]均高于单纯高血压组(P<0.05)。高血压合并高脂血症组患者的Eρ、β与BPV参数呈正相关,AC与BPV参数呈负相关(P<0.05)。结论E-Tracking技术可直接评估高血压合并高脂血症患者的颈动脉弹性,间接判断其BPV。     

高血压患者血压变异性和左室肥厚关系的研究

目的观察原发性高血压患者血压变异性与左心室肥厚的关系。方法原发性高血压患者60例,分别进行超声心动图检查和24 h动态血压监测,根据超声心动图测量指标计算所得的左心室重量指数(LVMI)分为左心室肥厚(LVH)组和无LVH组,分析比较两组间的血压均值和血压变异性。结果 LVH组24 h、白昼、夜间的收缩压和舒张压水平以及各阶段的收缩压和舒张压标准差均比无LVH组明显增大,差异有显著性;且LVH组LVMI高于无LVH组,差异有显著性。结论原发性高血压患者LVH的发生和血压变异性密切相关,血压变异性增高对左心室肥厚风险有一定预测价值。     

The association of peritoneal transport properties with 24-hour blood pressure levels in CAPD patients.

OBJECTIVES: We aimed to investigate the effects of peritoneal transport characteristics on blood pressure (BP) parameters, measured by 24-hour ambulatory blood pressure monitoring (ABPM), and on the development of left ventricular hypertrophy (LVH) in continuous ambulatory peritoneal dialysis (CAPD) patients. DESIGN: Cross-sectional and prospective design. SETTING: Tertiary-care center. PATIENTS: 25 CAPD patients (11 male, 14 female; mean age 47 +/- 14 years) were included. Mean time on CAPD was 22.9 +/- 18 months and all patients had been dialyzed for more than 6 months. The patients were divided into high, high-average, low-average, and low transport groups according to peritoneal equilibration test results. MAIN OUTCOME MEASURES: Daytime and nighttime systolic and diastolic BP and left ventricular mass index among the different peritoneal transport groups; changes in BP parameters before and after increase in ultrafiltration. RESULTS: On 24-hour ABPM records, 13 patients (52%) were found to be hypertensive. Both mean systolic and diastolic BP were significantly increased in high-transporter groups compared to low transporters in both daytime and nighttime BP parameters. Left ventricular mass index was higher in high transporters compared to low transporters, without reaching statistical significance: 160 +/- 23 vs 119 +/- 41 g/m2, p > 0.05. Following increase in ultrafiltration, mean systolic (145 +/- 13 vs 128 +/- 5 mmHg, p < 0.001) and diastolic (96 +/- 10 vs 81 +/- 3 mmHg, p < 0.001) BP decreased, and BP levels returned to normotensive levels in 6 (46%) of the 13 hypertensive patients, requiring discontinuation of antihypertensive drugs. CONCLUSION: Improvement in volume status resulted in a decrease in both daytime and nighttime BP. Differences in peritoneal transport properties were associated with the development of hypertension and LVH.     

老年高血压患者治疗过程中的动态血压特点和护理对策

目的探讨老年高血压患者治疗过程中的动态血压特点和护理对策。方法选取207例老年高血压患者进行24h动态血压监测,并分成一般老年组和高龄老年组,进行比较分析。结果高龄老年组的日间、夜间平均收缩压均高于一般老年组,日间、夜间平均舒张压均明显低于一般老年组,高龄老年组的脉压明显高于一般老年组,差异均具有统计学意义。高龄老年组昼夜节律异常发生率(反杓形+非杓形)占92.4%,一般老年组昼夜节律异常发生率(反杓形+非杓形)占93.3%,两组夜间下降率差异有统计学意义。结论 24h动态血压监测能更准确全面了解老年高血压患者的血压控制情况,为临床用药和护理提供更为合理的依据。     

The adjunctive effect of telmisartan in patients with hypertension uncontrolled on current antihypertensive therapy

This prospective, double-blind, randomised, parallel-group, multicentre study assessed the adjunctive effect of telmisartan monotherapy versus placebo in controlling blood pressure during the last six hours of the 24-hour dosing period. After a two-week run-in phase, 375 patients with essential hypertension uncontrolled on existing therapy were randomised to either placebo or telmisartan (40 mg uptitrated to 80 mg after four weeks, if needed) for eight weeks. Ambulatory blood pressure monitoring (ABPM) was conducted at randomisation (baseline) and treatment end. The change from baseline in diastolic blood pressure (DBP) over the last six hours (primary endpoint) was significantly greater with telmisartan than placebo (adjusted mean treatment difference in favour of telmisartan: -3.7 mmHg, 95% confidence interval (CI) -5.5, -1.9 mmHg, p < or = 0.001, n = 350), as was the reduction in 24-hour DBP (adjusted mean treatment difference: -5.0 mmHg, 95% CI -6.5, -3.5 mmHg, p < or = 0.001). Telmisartan also reduced mean systolic blood pressure significantly more than placebo over the last six hours and the entire 24-hour dosing interval. Responder rates (ABPM DBP, seated DBP, and overall [seated SBP/DBP]) at 8 weeks were significantly higher with telmisartan than with placebo (p < or = 0.01). All treatments were well tolerated. When added to existing antihypertensive regimens, telmisartan offers additional effectiveness while maintaining placebo-like tolerability.     

缬沙坦联合氢氯噻嗪对中、重度高血压患者的临床疗效及安全性研究

目的 分析氢氯噻嗪结合缬沙坦在中、重度高血压病人治疗中的效果及安全性。方法 选取我院于2019年2月~2022年2月内收治的164例中、重度高血压病人,依据其治疗手段差异分成2组。观察组89例病人实施氢氯噻嗪结合缬沙坦口服治疗,对照组75例病人实施非洛地平结合缬沙坦口服治疗,持续治疗12周。对比两组患者治疗前后的动态血压监测结果,对比两组患者血液中一氧化氮、内皮素、血清钾离子水平,对比两组患者治疗前后的心脏彩超结果,以及对比两组患者的不良反应发生率情况。结果 经过治疗,两组患者平均24h的收缩压(24hSBP)、平均24h的舒张压(24hDBP)、白天平均收缩压(dMSBP)、白天平均舒张压(dMDBP)、夜间平均收缩压(nMSBP)、夜间平均舒张压(nMDBP)均下降,且观察组患者的各项血压水平均低于对照组（P＜0.05）。治疗后,两组病人的血清一氧化氮升高、内皮素降低,且观察组病人血清内的一氧化氮浓度水平较对照组高（P＜0.05）,观察组病人的内皮素浓度水平较对照组病人低（P＜0.05）。两组患者的左心房容积指数、左心室后壁厚度(PWT)及左心室舒张期内径(LVEDD)均较治疗前下降(P＜0.05),观察组患者的左心房容积指数、PWT及LVEDD低于对照组(P＜0.05)。观察组患者治疗前后的血清钾离子浓度变化无统计学意义（P＞0.05）,对照组患者血清钾离子浓度提高,且浓度高于观察组患者（P＜0.05）。对照组患者高钾血症发生率高于观察组（P＜0.05）,但总不良反应出现概率方面,两组病人对比并无差异（P＞0.05）。结论 缬沙坦联合氢氯噻嗪能有效降低中、重度高血压患者的血压水平,有效缓解患者的左心室肥大、改善患者的血管内皮功能,稳定患者的血钾水平且不增加不良反应发生率。     

The effect of high-dose short-term ibuprofen on antihypertensive control with hydrochlorothiazide

The effect of high-dose ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), on the blood pressure of treated hypertensive patients was evaluated in a randomized, placebo-controlled, double-blind, crossover trial with 24-hour ambulatory blood pressure monitoring. Twelve middle-aged black women with essential hypertension, controlled with 50 mg hydrochlorothiazide per day, randomly received 3200 mg ibuprofen and a placebo for 8 days. Each treatment phase was separated by a 1-week washout period. Ambulatory blood pressure monitoring (ABPM), body weight, and 24-hour urinary excretion of sodium, creatinine, and prostaglandin E2 (PGE2) were determined at the end of each treatment phase. Mean (+/- SEM) 24-hour systolic and diastolic blood pressures were 122/85 (+/- 2.9/1.7) and 125/85 (+/- 3.0/1.1) during the placebo and ibuprofen phases, respectively. Mean ABPM during six consecutive 4-hour periods also revealed no significant differences between placebo and ibuprofen. We conclude that 3200 mg ibuprofen per day for up to 1 week induced little change in blood pressure in hypertensive who are receiving hydrochlorothiazide.     

Circadian rhythms in blood pressure in school-age children of normotensive and hypertensive parents

The purpose of this study was to describe the characteristics of blood pressure rhythms in school-age children and to compare the circadian mesors and amplitudes between children of normotensive parents and children of hypertensive parents. The sample consisted of 40 healthy children between 8 and 10 years old; 20 children had a parental history of hypertension and 20 did not. Blood pressure was measured every 2 hours during the day and every 90 minutes during the night for one 24-hour cycle using a Dinamap monitor equipped with an automatic printer. Cosinor analyses revealed statistically significant circadian rhythms for systolic and diastolic blood pressures in 12 of the 40 subjects. The acrophases for systolic and diastolic pressures occurred between 1200-1800 hours. The mean systolic mesor was 108.50 while the mean diastolic mesor was 61.41. The mean amplitudes were 8.85 for systolic pressure and 7.44 for diastolic pressure. No statistically significant differences in circadian mesors and amplitudes between children of normotensive parents and children of hypertensive parents were found.     

厄贝沙坦对老年高血压患者昼夜血压及心率变异性的影响

目的:观察厄贝沙坦对老年高血压病患者血压及心率变异性的影响。方法:140例原发性高血压患者服厄贝沙坦1次/d,共8周。治疗前和治疗8周后行24h动态心电图检查和24h动态血压监测。结果:厄贝沙坦能明显降低高压病患者的24h平均血压(P<0.01)、白昼平均血压(P<0.01)和夜间平均血压(P<0.01)。对夜间血压高于正常值的高血压病患者,厄贝沙坦能明显降低夜间血压(P<0.01),而对夜间血压已属正常者,厄贝沙坦无进一步降压作用(P>0.05),并使心率变异性时域指标SDNN、SDANN、SDNNI升高(P<0.05),频域指标HF升高(P<0.05),VLF和LF下降(P<0.05)。结论:厄贝沙坦在对老年原发性高血压患者控制血压的同时,也对改善心率变异性产生有益作用。