替米沙坦及氢氯噻嗪不同时间给药对高血压患者血压展峰的影响

Effect of administration of telmisartan and hydrochlorothiazide at different time on morning blood pressure surge in hypertensive patients

目的探讨替米沙坦及氢氯噻嗪不同时间给药对高血压患者血压晨峰的影响。方法选择2013年8月至2014年9月高血压患者120例，依据给药时间分为三组，每组40例，晨夜组清晨服用替米沙坦、夜间口服氢氯噻嗪，清晨组清晨同时口服替米沙坦、氢氯噻嗪，夜间组夜间同时口服替米沙坦、氢氯噻嗪。治疗2个月后比较三组血压指标。结果治疗后三组24h收缩压（24h SBP）、24h舒张压（24h DBP）、日间收缩压（dSBP）、日间舒张压（dDBP）、夜间收缩压（nSBP）、夜间舒张压（nDBP）、血压晨峰均低于治疗前，差异有统计学意义（P〈0．05），晨夜组24hSBP、dSBP、nSBP、血压晨峰低于清晨组及夜间组，差异有统计学意义（P〈0．05）。结论早晚分次服用替米沙坦及氢氯噻嗪血压晨峰控制效果优于顿服给药，应作为高血压优选给药方案推广应用。

Objective To investigate the effect of administration of telmisartan and hydrochlorothiazide at different time on morning blood pressure surge in hypertensive patients. Methods From August 2013 to September 2014, 120 patients with hypertensive were selected, and divided them into three groups according to delivery time, with 40 cases in each group. The morning night group received telmisartan in the morning and hydrochlorothiazide at night, the morning group was given telmisartan and hydrochlorothiazide at the same time in the morning, the night group was given telmisartan and hydrochlorothiazide at the same time during the night. The indexes of blood pressure in the three groups were compared for 2 months after the treatment. Results After the treatment, 24 h SBP, 24 h DBP, dSBP, dDBP, nSBP, nDBP and morning blood pressure surge of the three groups were lower than those before treatment, the differences were statistically significant（P 〈 0.05）. The 24 h DBP, dSBP, nSBP and morning blood pressure surge in the morning night group lower than those of the other two groups, the difference was statistically significant （ P 〈 0.05 ）. Conclusions The control effect of telmisartan and hydrochlorothiazide in divided doses in the morning or evening is better than administered at draught. It should be adopted as the preferred administration of drugs and is worth of popularization and application.