氨氯地平不同时间给药对非杓型高血压患者血压的影响

目的观察氨氯地平不同时间给药对非杓型高血压患者血压的影响。方法将80例非杓型高血压患者,由晨服氨氯地平5mg调整为晚间(5:00～9:00)口服,治疗4周后观察24h动态血压,并与治疗前进行比较。结果调整服药时间后杓型血压率为35%,高于调整前的0;且收缩压和舒张压均低于调整前,差异有统计学意义(P<0.05和P<0.01)。结论晚间服用氨氯地平对控制非杓型高血压优于晨起服药。     

不同服药时间对老年非杓型高血压降压疗效观察

目的：观察不同服药时间对老年非杓型高血压患者降压疗效及昼夜节律的影响。方法选取60～80岁的原发性非杓型高血压患者46例,随机分A组、B组。 A组予清晨服氨氯地平（压氏达）,B组予晚上服氨氯地平（压氏达）,每次5 mg共治疗6周;治疗前后皆进行24 h动态血压监测。结果2组治疗后在24 h和白天平均SBP及DBP下降比较无明显差异（P＞0．05）;但A组、B组昼夜节律改变,即夜间收缩压和舒张压夜间变异率分别为43．4％／86．9％、47．8％／82．6％,2组差异有显著性（P＜0．05）。结论非杓型高血压患者晚上服用降压药,能更好改善血压昼夜节律和达到降压疗效。     

替米沙坦不同给药时间治疗非杓型高血压的疗效观察

目的:探究替米沙坦不同给药时间治疗非杓型高血压的疗效分析.方法:选择我院非杓型高血压患者(轻中度)病例108例,随机分为晚服组和晨服组两组,每组54例,对两组分别在晚7时和早7时实施80mg替米沙坦口服,每天1次,连续服用12周.在治疗结束后对动态血压进行复查,同时对两组中血压昼夜节律的变化进行对比.结果:两组24h SBP、24hDBP、dSBP和dDBP等指标的比较差异无统计学意义(P>0.05),在nSBP和nDBP指标的比较上差异有统计学意义(P<0.05).结论:非杓型高血压在替米沙坦治疗下,血压水平得到有效的控制,晚上用药,则能有效实现将非杓型高血压向杓型高血压的转变.     

厄贝沙坦不同时间给药对非杓型高血压患者血压的影响

目的：观察厄贝沙坦不同用药时间对非杓型高血压病患者24 h昼夜血压节律的影响。方法入选的134例非杓型中度高血压患者,随机分为晨服厄贝沙坦组和晚服厄贝沙坦组,8周后复查诊室随机血压和动态血压。结果两组患者诊室随机血压都有明显降低,但晨起服药者白天收缩压和舒张压显著低于晚服组,差异具有统计学意义（P＜0.05）。晚服组恢复血压昼夜节律的比例为43.6％,晨起服药组恢复血压昼夜节律的比例为21.6％,两组间比较差异有统计学意义（P＜0.05）。结论晚服药可以更好地改善非杓型高血压患者的昼夜节律。     

替米沙坦不同给药时间治疗非杓型高血压患者的疗效观察

目的探讨替米沙坦不同给药时间治疗非杓型高血压患者的疗效。方法我院治疗的非杓型高血压患者162例,平均分为晨服组和晚服组各81例。晨服组患者于每日清晨8时,晚服组患者于每日晚间8时给予替米沙坦80mg口服治疗。对所有患者进行24h的动态血压监测。结果两组患者的24hSBP、24hDBP、dSBP以及dDBP相比较,差异无统计学意义(P>0.05);而两组患者的nSBP和nDBP相比较,差异有统计学意义(P<0.05);晚服组患者由非杓型高血型转变为杓型高血压的转变率明显高于晨服组患者的转变率(P<0.05)。结论替米沙坦可以有效的降低非杓型高血压患者的血压,同时晚间服用替米沙坦可以更好的将非杓型高血压转变为杓型高血压,值得在临床上推广使用。     

硝苯地平控释片对老年非杓型高血压患者昼夜节律变化的影响

目的研究硝苯地平控释片对老年非杓型高血压患者昼夜节律变化的影响。方法对58例老年非杓型高血压患者随机分为硝苯地平控释片晨起服药组（n=30）和晚上服药组（n=28）30mg/d,共治疗4周,服药前后进行动态血压监测,观察药物对血压昼夜变异率的影响。结果晚上服药组夜间平均SBP和DBP均较晨起服药组明显下降,对非杓型血压的昼夜节律调节有效率明显高于晨起服药组（SBP：89．29％,DBP92．86％）。结论对于老年非杓型高血压患者,硝苯地平控释片在晚上服用可以较好地纠正夜间的高负荷血压,维持正常的昼夜变化节律。     

替米沙坦不同时间给药治疗非杓型高血压疗效观察

目的:观察替米沙坦不同时间给药治疗非杓型高血压的疗效。方法:80例非杓型轻、中度原发性高血压患者随机分为晨服组与晚服组,2组均服用替米沙坦。晨服组于7∶00时给予替米沙坦(80 mg/片)1片,每日1次;晚服组于19∶00时给予替米沙坦(80 mg/片)1片,每日1次。12周后复查动态血压,比较2组血压昼夜节律的变化。结果:晨服组将非杓型血压纠正为杓型血压恢复昼夜节律的比例为20.0%,而晚服组将非杓型血压纠正为杓型血压恢复昼夜节律的比例为52.5%,2组间差异有统计学意义(P<0.01)。晚服组清晨时段(5∶00-9∶00)收缩压和舒张压显著低于晨服组(P<0.05)。结论:对于非杓型高血压患者,时辰化服用替米沙坦可以更好地改善血压昼夜节律。     

施慧达不同时间给药治疗非杓型高血压110例疗效观察

目的观察施慧达不同时间给药对非杓型高血压患者血压的影响。方法将110例非杓型高血压患者给予培哚普利4 mg,每日一次于早晨7点服用,服用2周后无效及未达显效者,随机分为晨服组与分开服药组,两组各55例,晨服组晨7点增加施慧达到5 mg,分开服药组于早晚7点分别加服施慧达2.5 mg,两组疗程均为4周,观察24 h动态血压;对两组治疗前后24 h平均血压和白天、夜间平均血压以及有效率进行统计分析。结果两组24 h平均血压下降无明显差异(P<0.05),总有效率无明显差异(P<0.05),分开服药组对控制夜间高血压与晨服组有明显差异(P<0.05)。结论早晚分开服药对控制非杓型高血压夜间血压优于单纯早晨服药。     

替米沙坦不同给药时间治疗非杓型社区高血压的疗效

目的：探讨替米沙坦不同给药时间治疗非杓型社区高血压的临床疗效。方法：从我院2013年6月～2016年6月收治的非杓型社区高血压患者中选取124例进行研究,随机分为两组,每组62例,均采用替米沙丁治疗,对照组于晨间给药,观察组于夜间给药,比较两组血压变化以及并发症发生率。结果：①治疗后,两组的24hSBP、24hDBP、dSBP和dDBP均无明显变化（P>0.05）,但nSBP和nDBP均明显改善,观察组优于对照组（P<0.05）。②经比较,观察组的血压类型转换率为75.81%,明显高于对照组的56.45%;并发症发生率为3.23%,明显低于对照组的17.74%,组间两项指标差异均存在统计学意义（P<0.05）。结论：替米沙坦治疗非杓型社区高血压具有显著疗效,能有效控制血压,减少并发症,而且夜间给药的效果优于晨间给药。     

替米沙坦不同给药时间治疗非杓型社区高血压患者的疗效分析

目的 分析替米沙坦不同给药时间治疗非杓型社区高血压患者的疗效.方法 抽取本社区内非杓型高血压患者共112例,抽取年限均在2012年5月～2013年10月之间,通过抽号将其随机分为两组,每组各56例.其中一组患者在早晨8时服用替米沙坦,称为对照组;另一组患者在晚间8时服用替米沙坦,称为观察组.对比两组患者的收缩压、舒张压、血压类型转变率以及并发症发生率.结果 观察组患者的收缩压、舒张压、血压类型转变率以及并发症发生率明显优于对照组患者(P＜0.05).结论 针对非杓型社区高血压患者,在晚间给予替米沙坦进行治疗效果显著,值得在临床上广泛推荐使用.     

Beneficial effects of the combination of amlodipine and losartan for lowering blood pressure in spontaneously hypertensive rats

A combination of antihypertensive agents can better control blood pressure and reduce the number and severity of side effects than a monotherapy. Since both CCBs (calcium channel blockers) and ARBs (angiotensin II receptor type-1 blockers) are current and effective antihypertensive drugs, this study assessed the synergistic antihypertensive effects as well as the optimal combination ratio of these two drugs. Amlodipine (3 mg/kg) or losartan (30 mg/kg) alone or a combination of each drug at a ratio 1:10 and 1:20 was administered orally to spontaneously hypertensive rats (SHR). A four-week treatment of either 3 mg/kg amlodipine or 30 mg/kg losartan alone decreased the systolic blood pressure (SBP). However, their combination significantly lowered the SBP from the 3^rd week, and there was a positive correlation between this reduction in blood pressure and the improvement in arterial endothelium-dependent relaxation. In addition, the combination therapy (1:20) decreased both the cardiac mass and left ventricular weight to a greater extent than with either amlodipine or losartan alone. The collagen content in the cardiac tissue was also significantly lower after the 4-week combination therapy (1:10). These results suggest that the combined use of amlodipine and losartan might be more effective in treating hypertension than a monotherapy.     

贝那普利联用氨氯地平对高血压患者血压、左室肥厚和心功能的影响

目的探讨贝那普利联用氨氯地平的降压效果以及逆转左心室肥厚、改善心功能的作用。方法将140例原发性高血压伴左心室肥厚患者随机分为贝那普利组（46例）、氨氯地平组（47例）、贝那普利联用氨氯地平组（47例）,分别接受贝那普利、氨氯地平、贝那普利加氨氯地平治疗12个月,观察期间定期测量血压,服药前后做超声心动图检查。结果用药后三组血压、超声心动图各指标较用药前变化显著（P〈0．05）,两单用药组比较各指标差异无显著性（P〉0．05）,联合用药组与单用药组比较各指标差异有显著性意义（P〈0．05）。结论贝那普利联合应用氨氯地平治疗原发性高血压降压效果好,逆转左室肥厚效果好,改善心功能作用明显,不良应少。     

Pharmacokinetics of amlodipine in hypertensive patients undergoing haemodialysis

Objective Amlodipine is a calcium antagonist of the dihydropyridine class. This study was performed to examine the single and multiple dose pharmacokinetics of amlodipine in hypertensive patients undergoing haemodialysis and to measure the index of accumulation during multiple dosage. An additional objective was to examine the dialysability of amlodipine by measuring its appearance in dialysate.Methods Seventeen hypertensive out-patients on haemodialysis were enrolled in this prospective, open, non-comparative phase-IV study. Fifteen patients completed the study. In the first part of the study, the patients were given a single oral 5-mg dose of amlodipine and blood samples taken 0, 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 72 and 144 h later. After a 4-week wash-out period, the patients were given a daily 5-mg oral dose of amlodipine for 30 days. The trough levels of amlodipine were measured on days 8, 15, 22 and 29. On day 30, the total time course of amlodipine concentrations in plasma was measured, as in the first part of the study. In addition, on day 15, the concentrations of amlodipine in dialysate were measured at the same time as in blood. Blood pressure and heart rate were measured and adverse events monitored. Pharmacokinetic parameters [C_max, t_max, k_el and AUC(0–24)] were calculated for the single dose and for the dose on day 30 and the accumulation index calculated on the basis of AUC(0–24) and C_max.Results The mean values of the single-dose pharmacokinetic parameters were as follows: C_max 3.83 µg l^–1, t_max 5.01, AUC(0–24) 59.90 µg l^–1 h, k_el 0.0177 h^–1. The mean accumulation index on the basis of AUC(0–24) was calculated as 3.70. Very low levels of amlodipine were detectable in dialysate fluid. The most frequently reported adverse events were hypertension, hypotension and muscle cramps.Conclusion There are only minor differences in the pharmacokinetics of amlodipine between healthy subjects and hypertensive patients on haemodialysis. Comparison with literature values for healthy volunteers suggests that amlodipine is rapidly and extensively absorbed in the patient group. Amlodipine is essentially not dialysable. These findings do not indicate a need for dose adjustment in renal failure patients on haemodialysis.     

Effect of benazepril amlodipine combination on fibrinolysis in hypertensive diabetic patients

Objective The aim of this study was to compare the effects of benazepril and amlodipine in monotherapy versus in combination with plasma t-PA and PAI-1 activity in hypertensive type-2 diabetic patients.Methods After an initial 6-week wash-out, single-blind placebo period, 38 patients, 17 men and 21 females, were randomly assigned to receive benazepril 10 mg o.d. or amlodipine 5 mg o.d. or their combination o.d. at the same dosage for 6 weeks in three crossover periods each separated by a 2-week placebo wash-out period (3×3 latin square). At the end of the placebo run-in period and of each treatment period, BP, plasma PAI-1 and tPA activity were evaluated.Results Both benazepril and amlodipine were similarly effective in reducing systolic blood pressure (SBP) (–17.6 mmHg with benazepril and –19.8 mmHg with amlodipine; P<0.001 versus placebo), and diastolic blood pressure (DBP) (–11.1 mmHg, –13.2 mmHg, respectively). Combination therapy produced greater reduction in SBP/DBP values (–28.3/–20.5 mmHg; P<0.001 versus placebo, P<0.01 versus benazepril and amlodipine). Benazepril monotherapy significantly decreased plasma PAI-1 activity (–8.4 IU/ml, P<0.05) while it did not influence t-PA activity (+0.02 IU/ml). Amlodipine monotherapy produced a significant increase in t-PA activity (+0.27 IU/ml, P<0.05) while it did not influence PAI-1 activity (+0.8 IU/ml). The amlodipine/benazepril combination produced both a significant decrease in plasma PAI-1 activity (–8.7 IU, P<0.05) and a significant increase in t-PA activity (+0.26 IU/ml, P<0.05).Conclusions These data suggest that in hypertensive type-2 diabetic patients, a population with an impaired fibrinolysis, the benazepril/amlodipine combination, may improve the fibrinolytic balance more than the single drugs.     

缬沙坦/氨氯地平复方制剂择时用药对非杓型高血压患者血压昼夜节律的影响

目的考察昼夜不同时间用药,缬沙坦/氨氯地平复方制剂对非杓型高血压患者降压作用的差异及其对血压昼夜节律的影响。方法非杓型高血压住院患者12例,均衡随机分2组。分别于8∶00及20∶00口服缬沙坦/氨氯地平复方制剂。于用药前及用药后d 3、d 7连续监测患者血压。用药前及用药7 d后取血测定血浆肾素(renin,Ren)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)、内皮素-1(endothelin-1,ET-1)水平。结果非杓型高血压患者的血压呈"昼高夜低、双峰一谷"现象,两峰值分别见于10∶00及18∶00;谷值见于2∶00。但患者昼夜血压差值缩小,杓型值仅为(4.10±1.74)%,呈明显非杓型特征。两时间点用药,均有良好的降压作用,用药后可使收缩压与舒张压的昼、夜均值、24 h均值明显下降(P<0.01)。但20∶00用药对患者夜间血压降低作用较快也较强,能明显改善患者的非杓型血压节律(P<0.01);相反8∶00用药则使非杓型血压节律有加重的倾向。用药7 d后患者血浆Ren、AngⅡ及ET-1水平升高。结论昼夜不同时间用药,缬沙坦/氨氯地平复方制剂对非杓型高血压患者的降压作用无明显差异,但对血压的昼夜节律有显著影响。休息期用药,可使高血压患者非杓型血压节律明显改善。     

氨氯地平联合厄贝沙坦不同给药时间对原发性高血压病人血压变异性和血压晨峰现象的影响

目的 比较氨氯地平和厄贝沙坦联合用药治疗原发性高血压病人不同服药时间的血压变异性、血压晨峰控制效果.方法 回顾性选取符合要求的于2014年2月至2017年12月来上海交通大学医学院附属瑞金医院诊治的84例轻中度原发性高血压,A组于06:30服用苯磺酸氨氯地平片5 mg、厄贝沙坦片150 mg;B组于18:30服用苯磺酸...     

国产苯磺酸氨氯地平对原发性高血压患者动态血压的影响

目的研究国产苯磺酸氨氯地平片剂对原发性高血压患者诊室血压（CBP）和动态血压的影响。方法应用动态血压监测及诊室血压测定方法。考察62例高血压患者经国产苯磺酸氨氟地平治疗4周前后24h血压、白昼及夜阀平均血压等的变化,并计算谷峰比值。结果治疗4周后．CBP、24h、白昼及夜间平均血压均显著降低。总有效率为89．5％。收缩压和舒张压的24h降压疗效谷／峰比值分别为77．23％和72.36％。结论每日1次口服国产苯磺酸氨氯地平片剂可维持24h平穗降压。     

Biochemical changes during amlodipine treatment in hypertensive patients

Twenty adult hypertensive patients mean age (52 (1.73) y) were treated with amlodipine 5 mg (8 patients) and 10 mg (12 patients) once daily for 12 weeks. There was a reduction in sitting and standing diastolic and systolic blood pressures in male and female patients.Plasma calcium, sodium, potassium, total proteins, albumin, globulins, phosphate, chloride, urea and haematological parameters were not significantly altered by amlodipine therapy in any patient. An increase in creatinine level was noted, which was not related to kidney dysfunction. We conclude that amlodipine 5 mg or 10 mg once daily is effective in male and female patients, and it does not alter biochemical and haematological values in hypertensive African patients.     

Bisoprolol/amlodipine combination therapy improves blood pressure control in patients with essential hypertension following monotherapy failure

Objective: The efficacy of a bisoprolol/amlodipine fixed-dose combination (FDC) in patients with essential hypertension who had not responded to bisoprolol or amlodipine monotherapy was investigated.

Research design and methods: In an 18 week, multicenter, randomized, comparative phase III study (ClinicalTrials.gov identifier: NCT01977794), patients with blood pressure uncontrolled by bisoprolol or amlodipine monotherapy (5?mg OD) began treatment with bisoprolol/amlodipine FDC 5/5?mg OD. Patients with controlled blood pressure (BP) at week 6/12 continued at current FDC strength, and patients with uncontrolled BP received FDC dose uptitration (maximum dose: 10/10?mg). The primary efficacy endpoint was change in systolic blood pressure (SBP) at week 18 versus baseline (corresponding to SBP under monotherapy), and secondary endpoints included change from baseline in SBP after week 6/12 and percentage of BP-controlled patients at week 6, 12 and 18. Safety was assessed by number/types of adverse events (AEs).

Results: Two hundred patients were randomized to treatment (100 with uncontrolled BP under bisoprolol and 100 under amlodipine monotherapy). Overall, 196 patients were eligible for analysis. The patient groups displayed similar mean SBP reductions from baseline by study end (bisoprolol monotherapy failure: 25.9?±?12.82?mmHg reduction; amlodipine monotherapy failure: 24.7?±?11.67?mmHg reduction; p?<?0.001 for both). Overall mean SBP decreased by 25.3?±?12.25?mmHg (p?<?0.001). Mean heart rate reductions were also observed (bisoprolol monotherapy failure: 6.6?±?9.67 bpm reduction; amlodipine monotherapy failure: 11.5?±?8.65 bpm reduction; p?<?0.001 for both). Most patients (83.2%) displayed BP control with bisoprolol/amlodipine 5/5?mg at 6 weeks. Treatment was well tolerated at all dose levels; treatment-related AEs (mostly of mild/moderate intensity) were reported by 52.5% of patients, with no severe or serious treatment-related AEs reported. As the study focused on hypertension, total cardiovascular risk was not assessed.

Conclusions: Bisoprolol/amlodipine FDC therapy is associated with significant BP improvements in patients with essential hypertension following monotherapy failure.