厄贝沙坦对老年高血压晨峰患者微量白蛋白尿的影响及降压疗效

Influence of irbesartan on urine microalbuminuria in elderly patients with morning blood pressure surge hypertension.

目的探讨厄贝沙坦对老年高血压晨峰患者尿微量白蛋白的影响及降压疗效。方法选择经24h动态血压监测血压未达标的老年高血压晨峰患者92例，观察睡前加用厄贝沙坦治疗后血压及血压晨峰的变化和对尿微量白蛋白的影响。结果治疗前92例老年高血压患者24h平均收缩压（140．1±12.7）mmHg，晨峰收缩压（45．6±10．8）mmHg，尿微量白蛋白[（58．6±3．7）mg／L]明显升高，与治疗前比较，睡前加服厄贝沙坦治疗后患者24h平均收缩压[（129．5±11．8）mmHg]下降（t=3．18，P〈0．05），晨峰收缩压[（14．2±4．1）mmHg]下降（t=5．74，P〈0．01），尿微量白蛋白[（31．7±3．1）mg/L]显著降低（t=5．24，P〈0．01）。结论厄贝沙坦可以有效降低老年高血压患者的血压及血压晨峰，提高血压达标率，降低尿微量白蛋白。

Objective To investigate the influence of irbesartan taken before bedtime on morning blood pressure surge and urine microalbuminuria in elderly patients with essential hypertension. Methods Ninety-two patients with uncontrolled hypertension were recruited in this study and their 24-hour ambulatory blood pressure monitoring profiles were collected for analysis. After irbesartan taken before bedtime, its influence on general blood pressure, morning blood pressure surge and urine micrealbuminuria was observed. Results Before irbesartan treatment,the average 24-hour ambulatory blood pressure was （140. 1 ± 12. 7 ）mm Hg, the morning blood pressure surge was（45. 6±10. 8）ram Hg,urine microalbuminuria level was （58. 6 ±3.7） mg/L. After irbesartan treatment, the average 24-hour ambulatory blood pressure decreased to （ 129. 5 ±11.8 ）mm Hg （ t = 3.18, P 〈 0. 05 ）, the morning blood pressure surge decreased to（ 14. 2 ± 4. 1 ）mm Hg（ t = 5. 74, P 〈 0. 01 ）, urine microalbuminuria level decreased to（31.7 ± 3.1 ） mg/L （t = 5.24, P 〈 0. 01 ）. Conclusions Irbesartan can effectively reduce the peak morning blood pressure,improve achievement ratio of blood pressure control, decrease urine microalbuminuria level in elderly patients essential hypertension.