卡托普利与缓释硝苯地平治疗对高血压病患者运动血压的影响

Effects of Captopril and Nifedipine on Post-exercise Blood Pressure in Patients with Essential Hypertension

目的:探讨原发性高血压(EH)经治疗血压稳定下降后,运动后血压反应是否恢复正常,以及观察卡托普利与缓释硝苯地平治疗有无差异。方法:观察正常成人22例,44例EH患者随机分为卡托普利和硝苯地平治疗2组。卡托普利始用12.5mg,2次/d,缓释硝苯地平始用10mg,2次/d,治疗2周,血压未降至正常者,分别加至25mg,2次/d或20mg,2次/d;观察3个月。观察结束前1周测定运动前、运动后即刻、5、10、15min血压,计血压恢复至运动前水平的时间(血压恢复时间)。结果:正常组运动后SBP和DBP升高幅度分别为(12.6±3.3)mmHg和(-0.1±2.6)mmHg,血压恢复时间为(5.9±2.0)min;高血压治疗2组虽然血压得到满意控制,但上述参数仍明显增加;但卡托普利组运动后SBP/DBP升幅明显小于硝苯地平组[(14.9±3.2)mmHg/(8.8±3.3)mmHg比(18.9±7.7)mmHg/(11.6±4.5mm)Hg,P均<0.05)];血压恢复时间更短[(9.8±4.6)min比(13.3±5.3)min,P<0.05)]。结论:高血压病患者即使血压得到有效控制,运动血压增幅和血压恢复时间仍明显大于正常血压者。与缓释硝苯地平比较,卡托普利治疗运动血压增幅更小,血压恢复时间更短。

Objective:To explore the effect of captopril and nifedipine therapy on post-exercise blood pressure(BP)in patients with essential hypertension(EH). Methods:patients were divided into two groups(n=22)treated with 12.5mg of captopril or 10mg of nifedipine twice a day atthe beginning respectively.Dosage was doubled if the level of blood pressure was still above normal reference.In the week before the end of the observation of three months,BP was measured at pre-exercise,post-exercise instantly,5,10,15mins respectively,and the BP increasing extent(the difference between pre-exercise and instant post-exercise BP)and the time BP recover to pre-exercise level(BPRT)were recorded.The control group was consisted of 22 healthy persons with normal BP.Results:Compared with group treated with nifedipine,the increased degree systolic BP and diastolic BP(SBP/DBP)was outstandingly lower (14.9±3.2/8.7±3.3vs.18.9±7.7/11.6±4.5mmHg,P<0.05,respectively);did as BPRT(9.8±4.6vs.13.3±5.3mins,P <0.05).All the parameters were significantly high in both EH groups than in control group.Conclusions:Even if the BP was controlled satisfactorily in EH patients,the post-exercise BP increasing extent was still higher,and BPRT longer than those of control group,Compared with nifedipine,captopril could descend the post-exercise BP increasing extent and BPRT.