坎地沙坦时间治疗学对非杓型高血压的影响

目的观察坎地沙坦不同给药时间对非杓型高血压患者血压水平及血压昼夜节律的影响。方法选择经24h动态血压监测属于非杓型高血压的需要药物治疗的1级高血压患者106例，随机（电脑随机数字表法）分为A组（早晨7：00服药）和B组（晚上7：00服药）。两组均选用坎地沙坦4mg，用药8周后观察用药前后24h动态血压参数，比较两组血压昼夜节律的变化。结果两组治疗前后血压比较，24h收缩压、24h舒张压、白昼收缩压、白昼舒张压、夜问收缩压、夜间舒张压均有明显下降，差异有统计学意义（P〈0．05）。两组治疗后24h舒张压、白昼收缩压、白昼舒张压、夜间舒张压比较，差异无统计学意义（P〉0．05）。B组治疗后24h收缩压、夜间收缩压比A组改善明显，差异有统计学意义（P〈0．05）。结论早晨或夜间服用坎地沙坦均能有效降低非杓型高血压的血压水平及改善血压昼夜节律，但夜间服药组在控制夜间收缩压和纠正血压昼夜节律方面更有优势。

Candesartan time therapeutic effects on non-dipper hypertension

Objectives To observe the candesartan time therapeutic effects on blood pressure levels and blood pressure circadian rhythm in patients with non dipper hypertension. Methods We selected 106 cases with non dipper hypertension （grade 1 hypertension） who needed medication by 24 h ambulatory blood pressure monitoring. The patients were randomly divided into A group （medication at 7：00 in the morning） and B group （19：00 medication）. Candesartan （4 mg） was used in the two groups. Blood pressure circadian rhythm of the two groups were measured by 24 h ambulatory blood pressure monitoring before and after 8 weeks treatment. Results Compared with those of before treatment, 24 h systolic blood pressure （SBP）, 24 h diastolic blood pressure （DBP）, dSBP, dDBP, nSBP, nDBP were significantly lower after 8 weeks treatment in both the two groups, the differences were statistically significant （P〈0.05）.Compared with those of before treatment, 24 h DBP, dSBP, dDBP, nDBP had no statistical significance in the two groups after treatment （P〉0.05）. 24 h SBP and nSBP in group B were significantly improved than those in group A （P〈0.05）. Conclusions Candesartan taken in the morning or at night can effectively reduce the blood pressure levels in patients with non dipper hypertension and improve blood pressure circadian rhythm, but taken in nighttime had better effect on systolic blood pressure control and blood pressure circadian rhythm.