不同降压药物对原发性高血压患者血压变异的影响

Research on impact of different anti-hypertensive agents on blood pressure variability in patients with primary hypertension

目的探讨氨氯地平片、依那普利、替米沙坦、美托洛尔对原发性高血压患者血压变异性(BPV)的影响。方法将120例原发性高血压患者分为氨氯地平片、依那普利、替米沙坦、美托洛尔组,每组30例。采用动态血压监测(ABPM)并分析患者治疗前与治疗后8周BPV。结果氨氯地平、替米沙坦降压作用较为显著,美托洛尔对舒张压的降压效果明显,依那普利降压作用不明显。氨氯地平和替米沙坦能在大多时间段降低BPV,氨氯地平主要降低日间舒张压变异,而替米沙坦夜间降低BPV明显;美托洛尔和依那普利24h血压变异中日间收缩压变异升高,夜间血压变异减小。结论氨氯地平片、依那普利、替米沙坦、美托洛尔均可降低原发性高血压患者的血压,但对患者BPV的影响在不同时间段存在差别,降压药物对BPV的作用与降压效应不一致。

Objective To explore the impact of amlodipine ,enalapril ,telmisartan and metoprolol on the blood pressure variability （BPV） in the patients with essential hypertension（EH） .Methods 120 patients with EH were divided into the amlodipine ,enala-pril ,telmisartan and metoprolol groups with 30 cases in each group .The ambulatory blood pressure monitoring （ABPM ） was adopt-ed and BPV before treatment and after 8-week treatment was observed .Results The anti-hypertensive effect of amlodipine and telmisartan was more obvious ,and the anti-hypertensive effect of metoprolol on the diastolic blood pressure was significant ,but the anti-hypertensive effect of enalapril was unobvious .Amlodipine and telmisartan lowered BPV at most time .Amlodipine mainly re-duced the daytime diastolic BPV ,while telmisartan reduced the night BPV significantly ;metoprolol and enalapril increased the day-time systolic BPV and decreased the nighttime BPV in 24 h BPV .Conclusion Amlodipine ,enalapril ,telmisartan and metoprolol can reduce the blood pressure in the patients with EH ,but their influences on BPV have difference .The impact of different anti-hyper-tensive drugs on BPV is inconsistent with the anti-hypertensive effect .