不同降压药对寒冷所致的高血压病患者血压和心率变化的影响

The influence of different anti-hypertension drugs on the changes of blood pressure and heart rate responses to cold in hypertensive patients

目的 评价不同降压药对寒冷所致的高血压病患者血压和心率的影响。方法 以有、无应用某一类降压药治疗 ,把 111例血压控制稳定的高血压病患者分成 β阻滞剂、利尿剂、钙阻滞剂、ACEI、ARB 5个组及无以上药物的 5个对照组。结果 ①气温骤降前患者的收缩压及舒张压控制达到目标血压 ;②气温骤降后 ,只有ARB治疗组收缩压和舒张压无明显改变 ,其余各组收缩压和舒张压均明显升高 ;③与对照组比较 ,寒冷所致的收缩压上升幅度 ,钙阻滞剂、ACEI两组显著增加 ;而利尿剂、ARB显著减少 ,β阻滞剂无区别 ;④与对照组比较 ,寒冷所致的舒张压上升幅度 ,利尿剂、β阻滞剂均显著增加 ,钙阻滞剂、ACEI及ARB无区别 ;⑤心率变化方面β阻滞剂自身对比和与对照组比较均明显下降 ;利尿剂组则明显上升 ,其余各组无变化。 结论 寒冷使高血压病患者收缩压和舒张压明显升高 ,而心率多无明显变化 ,在阻断收缩压上升方面利尿剂和ARB有效 ,在阻断舒张上升方面ARB有效。

Objective The purpose of this study was to determine the influence of different kinds of anti-hypertension drugs treatment on the changes of blood pressure and heart rate responses to cold in hypertensive patients.Methods 111 hypertensive patients were divided into five groups ,which were β receptor blocker group,diuretic drug group,calcium channel blocker group,ACEI group,ARB group and control group,according to the patterns of treatment.Results ①The blood pressure of all groups was reduced the target blood pressure before air temperature lower suddenly.②Only the ARB group,whose systolic and diastolic blood pressure was insignificantly changed after air temperature lower suddenly.But the others increased significantly.③Compared to the control group,the increase of systolic and diastolic blood pressure induced by cold was significant in group calcium channel blocker and ACEI.It was fewer in group of diuretic drug and ARB,there was no difference in β reaptor blocker group.④Compared to the control,the increase of diastolic blood pressure induced by cold was significant in group diuretic and β blocker.It had no difference in group calcium channel blocker,ACEI and ARB.⑤Heart rate was significantly decreased in β blocker group,but increased in duretic drug group.Not any change in the others.Conclusion Both systolic and diastolic blood pressure were increased significantly in all hypertensive patients during the clod.But there was not significant change in heart rate.Treatment in ARB could block the increase of systolic and diastolic blood pressure.Treatment of diuretic drug was beneficial only in systolic blood pressure.The others could not block the increase of blood pressure induced by cold.