家庭血压监测改善白大衣效应高血压患者左旋氨氯地平的降压达标作用

Impact of Home Blood Pressure Moritoring in Drug Treatment and Blood Pressure Target in White-Coat Effect Hypertension Patients Used L-Amlodipine

目的观察家庭血压监测改善白大衣高血压患者苯磺酸左旋氨氯地平药物降压达标的作用。方法选择白大衣效应家庭血压监测组76例,白大衣效应诊所血压监测组68例。随访前洗脱期1周,确认白大衣效应,每月随访1次,给予苯磺酸左旋氨氯地平片或联合氢氯噻嗪(HCTZ)治疗;观察随访前、后家庭血压监测和诊所血压监测值的差异比值、达标情况,随访期1年。结果(1)家庭血压监测组洗脱期后与随访期后血压的比较提示比值增大,(P<0.05),白大衣反应的差异减少。(2)家庭血压监测组≤3个月早期降压达标与诊所血压监测组比较显著增高(P<0.01)。(3)家庭血压组≤3个月早期降压达标率为68.42%,诊所血压组为45.77%。结论家庭血压监测在白大衣高血压患者的应用有助改善家庭和诊所血压差异比值,提高早期达标比例。

Objective To explore the impact of home blood pressure moritoring in drug treatment and blood pressure target in white - coat effect hypertension patients used L - amlodipine. Methods A total of 144 patients diagnosed with white- coat effect hypertension were selected. All patients had been given routine drug treatment used L -amlodipine and/or HCTZ, and were divided into home blood pressure moritoring （HBPM） group （n = 76） and clinic blood pressure （CBP） group （n = 68 ）. After 1 week washout period, white -coat effect had been identified for all study group patients. All patients were followed up once a month. Blood pressure of both group before and after of the follow up period had been recorded. The blood pressure target had been observed. Total follow - up period was 1 year. Results （ 1 ） The ratio of difference between blood pressure after washout period and the end of the follow up in HBPM group patients was increased,P 〈 0.05. The difference of white -coat effect was decreased. （2） The rate of patients who reach the target goal of blood pressure （ ≤3 months） in HBPM group were significantly higher than CBP group P 〈 0.01. （3） The rate of target goal less than 3months in HBPM group was 68.42% , and in CBP group was 45.77%. Conclusion Home blood pressure monitoring can improve the ratio Of blood pressure between HBPM and CBP, and can improve the early target goal in patients diagnosed with white -coat effect hypertension.