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

Effect of Captopril and Slow Release Nifedipine on Post-exercise Blood Pressure in Patients with Essential Hypertension

目的探讨原发性高血压(EH)降压治疗后,运动血压反应是否恢复正常及观察卡托普利与缓释硝苯地平治疗有无差异。方法以正常成人22例作为对照,44例EH患者随机分为卡托普利和硝苯地平治疗两组。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,逐渐加至25mg,2次/d或20mg,2次/d;观察3个月。于观察期结束前1周,测定运动前、运动终止后即刻、5、10、15min坐位血压,并计算SBP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;高血压治疗两组虽然安静血压得到满意控制,但上述参数仍明显高于对照组;与硝苯地平组比较,卡托普利组运动终止即刻SBP/DBP升幅明显更低[(14.9±3.2/8.7±3.3比18.9±7.7/11.6±4.5)mmHg,P均<0·05];血压恢复时间更短[(9.8±4.6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 slow release nifedipine therapy on postexercise blood pressure （BP） in patients with essential hypertension （EH）. Methods Patients were divided into two groups （n=22） and treated with 12.5 mg of captopril or 10 mg of nifedipine twice a day at the beginning of study. Dosages were doubled when BP was still above normal reference. In the week before the end of 3 months study, BP of pre-exercise, 5, 10 and 15 min after exercise was determined. BP increment （the difference between pre-exercise and post-exercise BP） and the time of SBP recover to pre-exercise level （BPRT） were measured. The control group consisted of 22 healthy persons with normal BP. Results Compared with group treated with nifedipine, the increases in systolic BP and diastolic BP （SBP/DBP） in captopril group was significantly lower [（14.9±3.2/8.7±3.3 vs 18.9±7.7/11.6±4.5） mm Hg, P〈0.05, respectively] as well as BPRT [（9.8±4.6 vs 13.3±5.3） min, P〈0. 05]. Conclusion Even if the BP was controlled satisfactorily in EH patients by either captopril or nifedipine, the post-exercise BP increment was still higher, and BPRT longer than those of control group. Compared with nifedipine, captopril attenuate the post-exercise BP increasing extent and BPRT more effectively.