失眠对高血压患者血压的影响

The influence of insomnia on blood pressure in patients with hypertension

目的研究失眠对高血压患者血压的影响及睡眠改善后患者血压的变化。方法高血压失眠患者271例，随机分为治疗组（137例）和对照组（134例），分别采用艾司唑仑和安慰剂治疗，观察患者第4、8、15天血压的变化：袖带坐位收缩压谷值和舒张压谷值与基线血压的变化、目标血压达标率，同时对患者进行睡眠障碍量表（sleep dysfuntion rating scale，SDRs）和汉密尔顿焦虑量表（Hamilton anxiety rating scale，HAMA）评价。结朵在治疗第8、15天，治疗组患者的收缩压谷值和舒张压谷值显著下降，而对照组下降不明显；治疗组目标血压的达标率也明显高于对照组（P〈0．01）。同时在治疗第8、15天，治疗组的SDRS和HAMA评分也较基线总分有显著下降；治疗组治疗失眠的总有效率为67．2％，对照组总有效率为16．4％，治疗组优于对照组（P〈0．01）。结论艾司唑仑治疗高血压失眠患者有显著疗效。失眠可严重影响高血压患者的血压变化，改善睡眠有利于改善患者的血压状态。

Objective To study the influence of insomnia on blood pressure in the patients with hypertension. Methods 271 cases of insomnia complicated with hypertension were randomly divided into two groups： the test group included 137 cases treated with estazolam,and control group included 134 cases treated with placebo. The changes of valley values of blood pressure including sedentary diastolic blood pressure and sedentary systolic blood pressure, rate of achieving aiming blood pressure,the scores of sleep dysfunction rating scale（SDRS） and Hamilton anxiety rating scale（HAMA） were recorded and compared between before treatment and on 4th day,8th day, and 15th day of treatment in both groups. Results The valley values of blood pressure in test group were significantly reduced on 8th day and 15th day of treatment, while those in control group had no change. Rate of achieving aiming blood pressure in test group was significantly higher than that in control group （P〈0.01）. The scores of SDRS and HAMA were also significantly reduced compared with baseline on 8th day and 15th day of treatment in the test group. The efficacy rate of treating insomnia was 67.2% in test group, which was significantly higher than that （16.4%） in control group （P〈0.01）. Conclusions Estazolam had better efficacy than placebo in treating insomnia in patients with hypertension. Insomnia could influence seriously the blood pressure in patients with hypertension, and when sleep was improved, the blood pressure in patients with hypertension could be reduced effectively.