高血压患者正规治疗前后夏冬季节昼夜血压变化观察

Summer and winter circadian blood pressure change before and after regular treatment in hypertensive patients

目的:观察原发性高血压患者接受正规治疗前后夏季与冬季血压昼夜变化情况。方法:选择本院2017年夏季、冬季收治的200例原发性高血压患者作为研究对象,按季节分为夏季组(100例)和冬季组(100例);两组均给予硝苯地平缓释片治疗,7d一疗程,对比两组患者治疗前、后的血压水平及血压节律指标;统计两组异常昼夜节律高血压的发生率。结果:与治疗前比较,治疗后两组患者24h平均脉压差均显著降低,24hSBP谷峰比、24hDBP谷峰比均显著升高(P<0.05或<0.01);且与夏季组比较,冬季组治疗后24h平均脉压差均显著升高,24hSBP谷峰比、24hDBP谷峰比均显著降低(P<0.05或<0.01)。与治疗前比较,两组治疗后清晨高血压[夏季组:(55.00%比29.00%),冬季组:(69.00%比43.00%)]、夜间高血压[夏季组:(38.00%比19.00%),冬季组:(52.00%比32.00%)]、非杓型高血压[夏季组:(51.00%比24.00%),冬季组:(65.00%比38.00%)]、深杓型高血压[夏季组:(12.00%比4.00%),冬季组:(23.00%比12.00%)]的发生率均显著降低(P<0.05或<0.01);冬季组治疗前、治疗后上述各项发生率均显著高于夏季组(P均<0.05)。结论:高血压患者存在季节性血压节律变化,经正规药物治疗可显著改善血压水平及血压昼夜节律紊乱,但冬季血压水平及昼夜节律紊乱发生率仍高于夏季。

Objective:To observe summer and winter circadian blood pressure(BP)change before and after regular treatment in patients with essential hypertension(EH).Methods:A total of 200 EH patients who were in our hospital in summer and winter of 2017 were selected.According to season,they were divided into summer group(n=100)and winter group(n=100);both groups received nifedipine sustained-release tablet,and 7d was regarded as a course.BP level and BP rhythm indexes were compared between two groups before and after treatment;incidence rate of abnormal circadian rhythm hypertension was counted in two groups.Results:Compared with before treatment,there were significant reductions in levels of 24h mean pulse pressure and significant rise in 24hSBP trough/peak(T/P)and 24hDBP T/P,P<0.05 or<0.01.compared with summer group,there was significant rise in 24h mean pulse pressure,and significant reductions in 24hSBP T/P and 24hDBP T/P in winter group after treatment,P<0.05 or<0.01.Compared with before treatment,there were significant reductions in incidence rates of morning hypertension[summer group:(55.00%vs.29.00%),winter group:(69.00%vs.43.00%)],nighttime hypertension[summer group:(38.00%vs.19.00%),winter group:(52.00%vs.32.00%)],non-dipper hypertension[summer group:(51.00%vs.24.00%),winter group:(65.00%vs.38.00%)]and deep dipper hypertension[summer group:(12.00%vs.4.00%),winter group:(23.00%vs.12.00%)]after treatment in two groups,P<0.05 or<0.01;incidence rates of above items in winter group were significantly higher than those of summer group before and after treatment,P<0.05 all.Conclusion:Seasonal BP rhythm change exists in EH patients.Regular medication can significantly improve BP level and BP circadian rhythm disorder,but BP level and incidence rate of circadian rhythm disorder in winter are still higher than those of summer.