4种抗高血压药物对血压和血压变异性的影响

目的:研究4种不同类型的抗高血压药物对血压变异性(blood pressure variability,BPV)的影响。方法:99例轻、中度原发性高血压患者,分别服用多沙唑嗪1mg/d(30例)、塞利洛尔100mg/d(18例)、咪达普利5mg/d(31例)和左旋氨氯地平2.5mg/d(20例),比较治疗前和治疗8周后动态血压和BPV的变化。结果:①多沙唑嗪、咪达普利和左旋氨氯地平组白昼的收缩压和舒张压分别降低9.67/6.64mmHg(1mmHg=0.133kPa)、5.06/2.39mmHg和9.65/5.35mmHg,而左旋氨氯地平组还降低夜间的收缩压和舒张压12.60/8.45mmHg;②多沙唑嗪组和左旋氨氯地平组能降低BPV,多沙唑嗪组24h收缩压、舒张压和白昼的收缩压变异分别减少19.0%、13.8%和12.5%(P<0.05或P<0.01),左旋氨氯地平组夜间收缩压、舒张压变异分别减少27.4%和18.1%(P<0.01和P<0.05)。结论:①多沙唑嗪、咪达普利和左旋氨氯地平组白昼的降压幅度较为明显,而左旋氨氯地平组还能降低夜间的血压;②多沙唑嗪组和左旋氨氯地平组能降低BPV。

Impacts of 4 different anti-hypertensive agents on blood pressure and blood pressure variability

Objective To observe the impacts of 4 different anti,hypertensive agents on blood pressure variability(BPV) in patients with essential hypertension (EH). Methods Ninety,nine patients with EH were divided into 4 groups, and were treated with doxazosin 1 mg/d (n=30), celiprolol 100 mg/d (n=18) or imidapril 5 mg/d (n=31) and L,amlodipine 2.5 mg/d (n=20), respectively. The changes of 24,hour average blood pressure and BPV were compared prior to and after 8 weeks of treatment. Results The reductive values of systolic/diastolic blood pressure at daytime in doxazosin group, imidapril group and L,amlodipine groups were 9.67/6.64, 5.06 /2.39 and 9.65/5.35 mm Hg, respectively. Furthermore, the reductive values of systolic and diastolic blood pressure at nighttime were 12.60 and 8.45 mm Hg in L,amlodipine group. The reduction of BPV was observed in doxazosin group and L,amlodipine group. In doxazosin group, the reductive values of systolic blood pressure variability, diastolic blood pressure variability at 24 h, and variabilities of systolic blood pressure at daytime were 19.0%, 13.8% and 12.5%, respectively(P<0.05 or P<0.01). In L,amlodipine group, the reductive values of systolic and BPV at night time were 27.4% and 18.1% respectively(P<0.01, P<0.05). Conclusions Doxazosin, imidapril and L,amlodipine demonstrate significant daytime blood pressure control. Furthermore, L,amlodipine could reduce the blood pressure at nighttime. Both doxazosin and L,amlodipine demonstrate their efficacy on BPV reduction.