比索洛尔/氢氯噻嗪复方片对轻、中度原发性高血压患者血压昼夜节律的影响

Effects of combination of bisorpolol and hydrochlorothiazide on circadian blood pressure in the patients with mild to moderate essential hypertension

目的:采用动态血压监测观察比索洛尔/氢氯噻嗪复方片(2.5mg/6.25mg,Lodoz)对轻、中度原发性高血压患者的血压昼夜节律的影响。方法:选择90例收缩压(SBP)<180mmHg、舒张压(DBP)95～109mmHg的轻、中度原发性高血压患者,口服Lodoz共4周,用24h动态血压监测评价治疗4周后动态血压和血压昼夜节律变化。结果:(1)治疗4周后,"杓型"和"非杓型"组的24hSBP/DBP分别降低9.57/7.75mmHg和12.61/9.88mmHg,日间SBP/DBP分别降低10.59/8.20mmHg和10.91/8.00mmHg,"杓型"和"非杓型"组间的24h和日间SBP/DBP治疗前后差异无统计学意义(P>0.05)。(2)"杓型"组夜间SBP/DBP降低6.12/5.65mmHg,"非杓型"组降低17.33/13.61mmHg,两组间差异显著(P<0.01)。(3)"杓型"组的夜间SBP/DBP下降百分比治疗前后无显著性差异(P>0.05),血压昼夜曲线仍为"杓型"。"非杓型"组的SBP/DBP夜间下降百分比在治疗后显著增加(P<0.01),SBP/DBP的夜间下降百分比两组间比较,差异显著(P<0.01)。结论:比索洛尔/氢氯噻嗪复方片(2.5mg/6.25mg/d)对"非杓型"组患者的夜间SBP/DBP降低作用较明显,有益于保持正常的血压昼夜节律。

Objective：To investigate the effects of combination of bisorpolol（2.5mg）and hydrochlorothiazide（6.25mg）（Lodoz）on circadian blood pressure in patients with mild to moderate essential hypertension.Methods：After 2 weeks of placebo run-in period,90 hypertensive patients whose sitting diastolic blood pressure（DBP）was between 95 and 109mmHg while systolic blood pressure（SBP）below 180mmHg, were treated with Lodoz for 4 weeks.Ambulatory blood pressure monitoring was conducted at the end of placebo run-in period and to the end of 4th week.Results：① After treatment with Lodoz once-daily for 4 weeks,the 24-hour mean of SBP/DBP reduced 9.57/7.75 mmHg in＂dipper＂group and 12.61/9.88 mmHg in＂non-dipper＂group.The reductions of day-time SBP/DBP were 10.59/8.20 mmHg in＂dipper＂group and 10.91/8.00 mmHg in＂non-dipper＂group.There was no significant difference between the two groups（P〉0.05）.②The nocturnal blood pressure decreased 6.12/5.65mmHg in＂dipper＂group and 17.33/13.61mmHg in＂non-dipper＂group,which was significantly different between the two groups（P〈0.01）.③The percentage of nocturnal blood pressure reduction changed slightly,without significant difference compared with the baseline value in＂dipper＂group（P〉0.05）.There was significant increas of the percentage of nocturnal blood pressure reduction in＂non-dipper＂group（P〈0.01）,compared with that of pre-therapy.Conclusion：Lodoz once-daily can effectively reduced the nocturnal blood pressure,especially for hypertensive patients with＂non-dipper＂pattern of blood pressure,which is good for keeping the normal circadian blood pressure.