不同时间服用依那普利对血压晨峰现象的影响

The influence of enalapril on morning blood pressure surge in mild hypertension patients

目的通过改变依那普利的服用时间来观察其对轻度高血压患者血压晨峰的影响。方法 42例轻度高血压患者给予依那普利10 mg上午(8～12点)服用,4周后监测24 h动态血压以观察白天、夜间和晨起血压情况;如果存在血压晨峰的患者则将依那普利改为晚上睡前服用,剂量不变,1周后再行24 h动态血压监测以观察白天、夜间和晨起血压情况。结果 4周后患者白天血压平均(129±10.5)/(80±6.7)mmHg,夜间血压平均(112±6.2)/(70±4.7)mmHg,晨起血压平均(142±9.5)/(89±5.5)mmHg,85.7%(36例)患者存在血压晨峰现象。改为睡前服用一周后白天血压平均(125±9.5)/(82±5.8)mmHg,与白天服用依那普利比较两者差异无统计学意义(P>0.05);夜间血压平均(110±7.3)/(68±6.6)mmHg,与白天服用依那普利比较两者差异无统计学意义(P>0.05);晨起血压平均(123±7.1)/(79±5.6)mmHg,与白天服用依那普利比较两者差异有统计学意义(P<0.05)。结论轻度高血压患者普遍存在血压晨峰现象,睡前服用依那普利能有效控制轻度高血压患者血压晨峰的发生。

Objective To investigate the influence of using Enalapril daily at different times on morning blood pressure surge in mild hypertension patients.Methods Forty-two mild hypertension patients received 10 mg Enalapril at 8 to 12 every morning.24-hour ambulatory blood pressure was monitored to get daytime,nighttime and morning blood pressure after four weeks.The patients who suffered from morning peak blood pressure would receive the same dosage of Enalapril before sleeping at night.24 hour ambulatory blood pressure was again monitored to investigate blood pressure at different daily time after one week.Results After four weeks,the patients＇ blood pressure came to（129±10.5）/（80±6.7） mmHg at daytime,（112±6.2）/（70±4.7）mmHg at night time,and（142±9.5）/（89±5.5）mmHg in the morning after getting up.About 85.7%（36 cases） of the total patients suffered from morning blood pressure surge.After the patients took Enalapril for a week before sleeping,the blood pressure reached up to（125±9.5）/（82±5.8）mmHg at daytime and（110±7.3）/（68±6.6）mmHg at nighttime,and there was no significant change compared with the group of taking Enalapril at daytime（P0.05）.However,the blood pressure[（123±7.1）/（79±5.6）mmHg]in the morning after getting up existed a significant difference（P0.05）.Conclusion Morning blood pressure surge commonly exist in the mild hypertension patients.The taking Enalapril before sleeping may effectively control morning blood pressure surge.