硝苯地平控释片氨氯地平对原发性高血压患者血压和心率变异性的影响

目的 :研究长效二氢吡啶类钙拮抗剂硝苯地平控释片与氨氯地平在治疗原发性高血压时对血压、心率变异性的影响。方法 :40例原发性高血压患者随机分为硝苯地平控释片组 (n=2 0 )及氨氯地平组 (n=2 0 ) ,分别予硝苯地平控释片 30～ 6 0mg/ d或氨氯地平 5～ 10 mg/ d,共 8wk。治疗前后行 HRV检测 ,并做对比分析。结果 :2组经 8wk治疗后血压均非常显著下降 (P<0 .0 1)。 2组治疗前后 HRV时域 6项指标 ,包括平均 R- R间期 (AVGR- R)、平均 R- R间期标准差 (SDAR- R)、平均 R- R间期的变异系数 (CV)、平均 R- R间期标准差的均值 (SD)、平均 R- R间期标准差的标准差 (SDSD)、相邻 R- R间期差值平方根的均值 (rm SASD)及频域 4项指标 ,包括低频 (L F 0 .0 2 5～ 0 .1Hz)、中频 (MF 0 .1～ 0 .2 Hz)、高频 (HF 0 .2～ 0 .3Hz)、低频 /高频 (R:L F/ HF)均无变化 (P>0 .0 5 )。结论 :长效二氢吡啶类钙拮抗剂治疗原发性高血压病 ,在降血压时对心率变异性无不利影响。

Comparison of nifedipine controled-release tablet vs amlodipine on heart rate variability in hypertensive patients

AIM: To evaluate the effects of 2 calcium channel blockers, nifedipine controled release tablet and amlodipine on heart rate variability in hypertensive patients. METHODS: Forty patients with essential hypertension were randomized to nifedipine group ( n= 20) or amlodipine group ( n= 20). After 2 wk run in period, patients were treated with either nifedipine 30-60 mg/d or amlodipine 5-10 mg/d for 8 wk. Time and frequency domain measures of heart rate variability were obtained from 1 h Holter recording, before and after 8 wk of treatment. RESULTS: Blood pressure values decreased with 2 drugs. Time domain measures of HRV, including the average R R intervals (AVGR R), standard deviation of the averages of normal R R intervals (SDAR R), the coefficient of variation (CV), the mean differences of standard deviation of the average R R intervals (SD), standard deviation of differences between adjacent R R intervals (SDSD) and the square root of the mean squares of differences between adjacent R R intervals (rmSASD), comparable at baseline, were unchanged in 2 groups. Frequency domain measures of HRV, including low frequency power (LF 0 025-0 1 Hz), medium fequency power (MF 0 1-0 2 Hz), high frequency power (HF 0 2-0 3 Hz), the low to high frequency power R(LF/HF)], comparable at baseline, were unchanged in 2 groups. CONCLUSION: Both nifedipine and amlodipine have no unfavorable effect on cardiac autonomic control in treating hypertension.