硝酸酯类药物对老年单纯收缩期高血压患者脉压的影响

目的观察硝酸酯类药物对老年单纯收缩期高血压(ISH)患者脉压(PP)的影响。方法85例ISH患者随机分为对照组43例和治疗组42例,两组均给予非洛地平缓释片5mg,每日1次口服,对照组加用美托洛尔12.5~25.0mg,每日2次口服,治疗组加用单硝酸异山梨酯(ISMN)10~20mg,每日2次口服,疗程12周。结果两组患者收缩压(SBP)均降至正常(P<0.01);但是,治疗组从第4周开始SBP下降幅度大于对照组(P<0.05);治疗组从第2周开始舒张压(DBP)下降幅度小于对照组(P<0.05),并且PP减小幅度亦小于对照组(P<0.05),第4周差距进一步加大(P<0.01)。结论硝酸酯类药物能降低ISH患者的SBP,而对DBP影响不大,能使PP减小,对老年ISH患者降压治疗有益。

Effect of nitric acid ester on pulse pressure in elderly patients with isolated systolic hypertension

Objective To investigate the effect of nitric acid ester on pulse pressure(PP) in elderly patients with isolated systolic hypertension(ISH). Methods Eighty-five patients were randomized to receive felodipine(5 mg/d) combined with metoprolol (25-50 mg/d,n=43,control group) or isosorbide mononitrate(ISMN;20-40 mg/d,n=42,treatment group) for 12 weeks. Dynamic changes in systolic blood pressure(SBP),diastolic blood pressure(DBP) and PP were determined. Results Both the control group and treatment group based treatments effectively lowered mean 24 h SBP(P<0.01).However, from the 4th week of treatment, the magnitude of reduction in SBP was greater in treatment group than that of control group(P<0.05). After four weeks of treatment, the magnitude of reduction in DBP was less than that of control group(P<0.01). The greater reduction in SBP and less reduction in DBP resulted in significant decreases in pulse pressure in treatment group(P<0.01). Conclusions Nitric acid ester can decrease SBP in ISH and has less effect on DBP, leading to decreasing in PP which is beneficial to elderly.