常用抗高血压药物对血压的时间生物学特征的影响

Effects of anti-hypertensives on the chronobiological indices of blood pressure

目的 :探讨 3类常用抗高血压药物对非杓型的高血压病患者BP的时间生物学特征的影响。方法 :共入选非杓型BP分布的高血压病患者 16 1例 ,将其随机分为 3组 ,分别给予赖诺普利 (10mg·d-1) ,非洛地平 (2 5mg·d-1) ,或氢氯噻嗪 (5 0mg·d-1) ,并于治疗前后行 2 4h动态BP监测。采用余弦拟合方法分析治疗前后患者BP时间生物学特征的改变。结果 :赖诺普利组与非洛地平组治疗后 2 4hBP均值明显降低 ,但其振幅、峰值相位无变化 ;氢氯噻嗪治疗降压效果不甚理想 ,但显著增加了患者BP的夜间降低幅度 ,使患者BP由非杓型转变为杓型分布。结论 :氢氯噻嗪治疗可能使非杓型分布的高血压病患者的BP转变为杓型分布 ,从而有助于降低患者相关并发症的发生率。

AIM: To investigate the effects of 3 anti hypertensives,on the chronobiological features of blood pressure in non dipper hypertensive patients. METHODS: One hundred and sixty one cases of such patients were included and were allocated into 3 groups and were given lisinopril(10 mg·d -1 ), felodipine (2 5 mg·d -1 ),hydrochlorothiazide(50 mg·d -1 ), respectively. Ambulatory blood pressure monitoring of 24 h was conducted on every patient before and 3 wk after treatment.Cosinor analysis was introduced to deal with circadian data. RESULTS: Average blood pressure was decreased significantly after treated with lisinopril and felodipine but without changes on its amplitude and acrophase in cosinor curves.However,in patients treated with hydrochlorothiazide,many of those changed to dippers although their 24 hour average blood pressure was only slightly decreased. CONCLUSION: It is concluded that after treatment with hydrochlorothiazide non dipper hypertensives change to dippers,which would be helpful in preventing target organ complications.