短效联合与长效单药抗高血压治疗对随诊间收缩压变异性的影响

The effects between single long-acting and combination of short-acting antihypertensive drugs treatment on visit-to-visit systolic blood pressure variability

目的分析短效联合与长效单药抗高血压药物治疗对随诊间收缩压变异性的影响。方法自2009-04-2010-05对开滦集团有限责任公司井下及井下辅助单位在职高血压职工进行抗高血压治疗(注册号ChiCTR-TNC-11001489)。治疗期间每两周随访一次并测量血压,观察治疗前后高血压职工的收缩压变异性(BPV)及收缩压BPV下降值,并使用多元线性回归分析影响基线收缩压BPV及治疗后收缩压BPV下降值的因素。结果治疗12月后短效联合组与长效单药组收缩压标准差(SD)分别下降了(1.6±9.0)和(2.4±10.0)mmHg,组间比较差异有统计学意义(P<0.01);多元线性回归分析显示影响基线收缩压SD的因素为年龄、基线收缩压;影响治疗后12月收缩压SD下降值的因素为药物分组、治疗第12月血压下降值。结论长效单药抗高血压治疗降低随诊间收缩压BPV的疗效优于短效联合抗高血压治疗。

Objective To explore the effects between single long-acting and combination of short-acting antihypertensive drugs treatment on visit-to-visit systolic blood pressure variability （SBPV） in hypertensive patients. Methods From April 2009 to May 2010, the underground miners on-the-job with hypertension of kailuan group （ChiCTR-TNC-11001489） were enrolled in our study. They were followed up and the blood pressure were measured every two weeks during the treatment period. The SBPV and the decline of SBPV were observed before and after the treatment, and the multiple linear regression was used to analyze the relative factors that affected the baseline SBPV and the change of SBPV after the treatment. Results The systolic blood pressure （SBP） standard deviation （SD） decreased （1.6±9.0） and （2.4±10.0）mm Hg in the combinations of short-acting group and single longacting group after 12 months of treatment, respectively （P〈0.01）. Multiple linear regression analysis showed that the age and the baseline SBP were the relative factors that affected the baseline SBP SD in the hypertensive patients, and it also showed that the antihypertensive drugs and the decrease of SBP on the 12th month post-treatment were the relative factors of the decrease of SBP SD after the treatment. Conclusion The effects of single long-acting antihypertensive drugs treatment on visit-to-visit SBPV is better than combinations of short-acting antihypertensive drugs treatment.