不同服药方法对高血压患者降压有效性和平稳性的影响

目的 探讨不同服药方法 对于高血压治疗有效性和平稳性的影响.方法 采用随机、单盲、平行对照设计,对90例2级及以上原发性高血压患者,随机分为早晨服用非洛地平和缬沙坦组(A组30例,男15例,女15例),早晨服用缬沙坦晚上服非济地平组(B组30例,男17例,女13例),早晨服用非洛地平晚上服缬沙坦组(C组30例,男16例,女14例),患者均于服药前及服药后2周进行动态血压监测求得平滑指数等指标.结果 服药2周后,各组夜间时段及24 h的平均收缩压的下降值依此为:19.3、28.8、30.5、22.9、28.3及29.1 mm Hg(1 mm Hg=0.133 kPa).组间比较,A组0.05).夜间及24 h平均收缩压平滑指数符组依次为:2.43,3.12,3.22及1.92,2.49,2.27,组间比较,夜间平均收缩压平滑指数A组0.05).结论 联合用药的降压效果显著,早晚分次服药较早晨顿服两种药物能更有效控制夜间血压,早晚分次服药使夜间及24 h血压下降更平稳.

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

Objective To investigate the impact of antihypertensive medication timing on degree and stability of blood pressure (BP) lowering in patients with moderate and severe essential hypertension. Methods Ninety patients were randomly assigned to take Valsartan and Felodiping together in the morning (group A), Valsartan in the morning and Felodiping in the evening (group B) or Felodiping in the morning and Valsartan in the evening (group C, n=30 each). The morning dosage was titrated if the goal blood pressure was not achieved. Ambulatory blood pressure monitoring (ABPM) was performed on the first and 14~(th) day of medication. Results The BP reductions during nighttime and twenty-four in group B and C hours were similar (P>0.05) but were significant more than those in group A (P<0.05). The smoothness indexes of mean systolic, mean arterial blood pressure during nighttime and twenty-four in group B and C were similar but significantly higher than that in group A (P<0.05). The smoothness index of diastolic pressure at nighttime in group B and C was similar but signifieantly higher than that in group A (P<0.05). Conclusion More significant and stable antihypertensive effects could be achieved by taking the two antihypertensive medications separately in the morning and at evening compared that taken the two drugs together in the morning.