不同给药时间对非杓型老年高血压患者血压昼夜节律及清晨血压的影响

Effect of different drug administration time on blood pressure circadian rhythm and morning blood pressure of non dipper type dosing in elderly hypertensive

目的探讨不同给药时间对非杓型老年高血压患者血压昼夜节律及清晨血压的影响。方法入选非杓型老年高血压患者98例,随机分成两组,分别在清晨及晚上给予苯磺酸氨氯地平5 mg治疗12周,并于治疗前后进行24h动态血压监测,记录治疗前后两组白天、夜间平均血压变化,并计算出血压昼夜差值百分比,并于治疗期间通过家庭自测血压方法测量清晨血压,并计算出清晨血压平均值及达标率。结果 12周后晚上服药组血压昼夜差值百分比高于清晨服药组(P<0.05),且家庭自测清晨血压无论是SBP还是DBP,晚上服药组均低于清晨服药组,且达标率较好(P<0.05)。结论晚上服药组能更好地调整非杓型老年高血压患者血压昼夜节律并降低清晨血压。

Objective To investigate effect of different drug administration time on blood pressure circadian rhythm and morning blood pressure of non dipper type dosing in elderly hypertensive. Methods 98 elderly non dipper hypertensive patients were selected, randomly divided into two groups, and were given amlodipine besylate 5rag for 12 weeks in the early morning and evening. Before and after treatment, two groups had monitored ambulatory blood pressure, recorded the mean blood pressure changes in day and night, calculated the percentage of circadian blood pressure difference, measured the early morning blood pressure with family self testing during, and calculated the morning blood pressure mean value and standard rate. Results After 12 weeks, the blood pressure circadian difference giving drug at night were higher than in the morning （P〈0.05）. No matter the family self testing early morning blood pressure in SBP or DBP, evening medication group were lower than control group in the morning, and the success rate was better （P〈0.05）. Conclusion Evening medication group adjusts better non dipper circadian rhythm of blood pressure in patients with essential hypertension in elderly patients and reduces the morning blood pressure.