美托洛尔与非洛地平对老年高血压病人心率变异性的影响

目的　观察美托洛尔和非洛地平对老年高血压病人降压治疗后心率变异性的改变。方法　 10 0例年龄 6 0岁以上单纯收缩期高血压病人随机分为美托洛尔组和非洛地平组 ,用药前、后作动态血压和心率变异性检查。结果　美托洛尔组和非洛地平组的降压效果相似 ,两组的 2 4小时平均收缩压分别从 16 3± 13mm Hg、16 2± 15 m m Hg降至 148± 17mm Hg、15 0± 14mm Hg(P<0 .0 1) ,2 4小时平均舒张压分别从 81± 5 m m Hg、80± 4mm Hg降至 79± 4mm Hg、77± 4m m Hg(P<0 .0 5 )。然而两组的心率变异性改变却截然相反 ,2 4小时平均 R- R间期标准差美托洛尔组从 33± 3ms增至 34± 3ms(P<0 .0 5 ) ,非洛地平组则从 32± 4m s减少至 31± 4ms(P<0 .0 5 ) ;2 4小时相邻 R- R间期差大于 5 0 ms所占总心动次数的百分比 ,美托洛尔组从 11± 8(% )增至 14± 5 (% ) (P<0 .0 1) ,而非洛地平组则从 12± 8(% )降至 9± 6 (% ) ,但无统计学意义 (P>0 .0 5 )。结论　 β受体阻滞剂美托洛尔和钙通道阻滞剂非洛地平有相似的降压效果 ,对心率变异性的作用却不相同

Compared investigation of effectis of Metoprolol and Felodipine on heart rate variability in the elderly patients with hypertension

Objective To observe the change of heart rate variability after Metoprolol and Felodipine treatment in the elderly patients with hypertension. Methods 100 hypertensive patients above 60 years old with primary hypertension were randomly divided into two groups: Metorolol group and Felodipine group. 24h ambulatory blood pressure monitoring and heart rate variability before and after treatment were examined. Results Effectiveness of decomression in Metorolol group is similar with that in Felodipine group.24h average systolic pressure was dropped from 163±13 mmHg,162±15 mmHg to 148±17mmHg,150±14 mmHg(P<0.01),respectively,24h average diastolic pressure was dropped from 81±5 mmHg,80±4 mmHg to 79±4 mmHg,77±4 mmHg(P<0.05),respectively. But the changes of heart rate variability in the two groups was opposite. 24h average R-R interval standard deviation in Metorolol group was increased from 33±3ms to 34±3ms(P<0.05)and that in the Feloipine group was decreased from 32±4ms to 31±4ms(P<0.05).The percentage of 24h close R-R interval surplus above 50ms in total beat times,in Metoprolol group was increased from 11±8(%)to 14±5(%)(P<0.01),in the Felodipine group was decreased from 12±8(%)to 9±6(%)although this change had no statistical significance(P>0.05). Conclusion β-receptor blocker Metoprolol has similar effect on decompression to calcium channel blocking agent Felodipine.But their effect on heart rate variability is different.