时辰药理学为导向的降压方案用于老年非杓型高血压患者治疗中对血管内皮功能及血压的影响

Effect of Chronopharmacologically Oriented Antihypertensive Regimen on Vascular Endothelial Function and Blood Pressure in Elderly Patients with Non-arytenoid Hypertension

目的 探讨时辰药理学为导向的降压方案用于老年非杓型高血压患者治疗中对血管内皮功能及血压的影响。方法选取2022年3月至2023年3月咸宁市第一人民医院收治的86例老年非杓型高血压患者作为研究对象,按照随机数字表法分为对照组与观察组,各43例。所有患者均口服氢氯噻嗪,对照组患者加用苯磺酸左旋氨氯地平治疗方案(早晨7:00~9:00),观察组患者加用苯磺酸左旋氨氯地平治疗方案(晚上睡前19:00~21:00)。比较两组患者血管内皮功能、血压水平、血压达标率。结果 治疗后,两组一氧化氮(NO)、内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)水平优于治疗前(P<0.05),且观察组优于对照组(P<0.05)。治疗后,观察组24 h收缩压、白天平均收缩压、夜间平均收缩压、晨起平均收缩压、24 h舒张压、白天平均舒张压、夜间平均舒张压、晨起平均舒张压低于对照组(P<0.05)。两组白天血压达标率比较差异无统计学意义(P>0.05);观察组夜间血压达标率与全天血压达标率高于对照组(P<0.05)。结论 时辰药理学为导向的降压方案可改善老年非杓型高血压患者的血管内皮功能,有效控制血压,提高血压达标率。

Objective To explore the effect of chronopharmacologically oriented antihypertensive regimen on vascular endothelial function and blood pressure in elderly patients with non-arytenoid hypertension.Methods A total of 86 elderly patients with non-aryten-type hypertension admitted to the First People's Hospital of Xianning City from March 2022 to March 2023 were selected as the study objects,and were divided into control group and observation group according to random number table method,with 43 cases in each group.All patients were given oral hydrochlorothiazide,control group was treated with levamlodipine besylate(7:00 am to 9:00 am),observation group was treated with levamlodipine besylate(19:00 PM to 21:00 PM before going to bed).Vascular endothelial function,blood pressure level and blood pressure compliance rate were compared between the two groups.Results After treatment,the levels of nitric oxide(NO),endothelin-1(ET-1) and angiotensin Ⅱ(AngⅡ)in two groups were better than those before treatment(P<0.05),and the observation group was better than the control group(P<0.05).After treatment,24 h systolic blood pressure,daytime mean systolic blood pressure,night mean systolic blood pressure,morning mean systolic blood pressure,24 h diastolic blood pressure,daytime mean diastolic blood pressure,night mean diastolic blood pressure and morning mean diastolic pressure in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the daytime blood pressure compliance rate between the two groups(P>0.05).The night blood pressure meeting rate and day blood pressure meeting rate of observation group were higher than those of control group(P<0.05).Conclusion Chronopharmacology-oriented antihypertensive regimen can improve vascular endothelial function,effectively control blood pressure in elderly patients with non-arytenoid hypertension,and increase the rate of blood pressure compliance.