比较不同时间服用缬沙坦对高血压患者血压变异性的影响

Comparison of effects of valsartan taken at different time on blood pressure variability in patients with hypertension

目的比较不同时间服用缬沙坦及苯磺酸氨氯地平片对原发性高血压(高血压)患者血压变异性(bloodpressure variability,BPV)的影响。方法采用随机数字法将120例轻-中度高血压患者分成3组,分别为日间口服缬沙坦组、夜间口服缬沙坦组、日间口服苯磺酸氨氯地平组,治疗前、后进行24 h动态血压监测。以动态血压变异标准差作为血压变异性指标,比较3个月后3种治疗方案对血压及血压变异性的影响。结果 3种治疗方案均能有效降低血压,与治疗前比较差异有统计学意义(P<0.05)。在控制BPV方面,日间口服缬沙坦组的BPV改善不明显,与治疗前比较差异无统计学意义(P>0.05);与治疗前比较,夜间口服缬沙坦组[收缩压变异性:(11±3)mm Hg vs.(15±4)mm Hg(1 mm Hg=0.133 kPa),P<0.05;舒张压变异性:(7±2)mm Hg vs.(10±4)mm Hg,P<0.05]和苯磺酸氨氯地平组[收缩压变异性:(10±3)mm Hg vs.(16±3)mm Hg,P<0.05;舒张压变异性:(6±2)mm Hg vs.(11±2)mm Hg,P<0.05]的24 h动态血压变异性降低,差异有统计学意义;苯磺酸氨氯地平组在改善BPV方面仍优于夜间口服缬沙坦组,差异有统计学意义(P<0.01)。结论与日间服药相比,夜间服用缬沙坦能更有效改善血压变异性。

Objectives To compare the effects of valsartan and amlodipine taken at different time on blood pressure variability （BPV） in patients with essential hypertension. Methods A total of 120 patients with mild to moderate essential hypertension were randomly divided into three groups：daytime oral administration of valsartan group, nighttime oral administration of valsartan group, daytime oral administration of amlodipine group. Their 24 h ambulatory blood pressures were recorded before and after treatment. The standard deviation of ambulatory BPV was taken as the indicator of blood pressure variability. Three treatment programs on blood pressure and BPV were compared after 3 months. Results All of the three treatment programs effectively lowered blood pressure （P〈0.05）. Daytime oral administration of valsartan did not obviously improve BPV （P〉0.05）. Compared with pre-treatment, the 24-hour ambulatory BPV of nighttime oral administration of valsartan group [systolic blood pressure variability： （11±3） mm Hg vs. （15±4） mm Hg, P〈0.05; diastolic blood pressure variability： （7±2） mm Hg vs. （10±4） mm Hg, P〈0.05 and amlodipine group [systolic blood pressure variability： （10-＋3） mm Hg vs. （16±3） mm Hg, P〈0.05; diastolic blood pressure variability： （6±2） mm Hg vs. （11 ±2） mm Hg, P〈0.05] effectively reduced. BPV improved in amlodipine group more effectively than nighttime oral administration of valsartan group （P〈0.01）. Conclusions Compared with daytime medication, hightlime oral administration of valsartan can better improve BPV.