不同时间段服用美托洛尔对老年夜间高血压的影响

Effect of taking metoprolol at different time periods on nocturnal hypertension in the elderly

目的探讨不同时间段服用美托洛尔对老年夜间高血压的影响及安全性。方法选取2022年1月至2023年7月就诊于新余北湖医院的70例老年高血压患者,按照随机数字表法分为夜药组(35例)、晨药组(35例)。晨药组于每天上午8:00口服,夜药组于每天晚上20:00口服。比较2组动态血压指标、血压变异性、夜间血压下降度及不良反应。结果2组治疗后动态血压指标均低于治疗前,差异有统计学意义(P<0.05)。治疗后,2组昼间收缩压、夜间收缩压、昼间舒张压、夜间舒张压比较,差异有统计学意义(P<0.05),而24 h平均收缩压、24 h平均舒张压水平比较,差异无统计学意义(P>0.05)。治疗后,2组血压变异性指标均低于治疗前,且夜药组低于晨药组,差异有统计学意义(P<0.05)。治疗后,2组夜间血压下降度高于治疗前,且夜药组高于晨药组,差异有统计学意义(P<0.05)。2组治疗后24 h平均心率比较,差异无统计学意义(P>0.05)。治疗期间,2组均未发生明显不良反应。结论美托洛尔治疗老年夜间高血压安全性较高,且夜间服用可更好地控制血压,降低血压变异性,改变血压昼夜节律。

Objective To investigate the effect and safety of metoprolol in different time periods on nocturnal hypertension in the elderly.Methods A total of 70 elderly patients with hypertension who were treated in Xinyu Beihu Hospital from January 2022 to July 2023 were selected and divided into the night medicine group(35 cases)and the morning medicine group(35 cases)according to random number table method.The morning medicine group was taken orally at 8:00 every morning,and the night medicine group was taken orally at 20:00 every day.Ambulatory blood pressure index,blood pressure variability,nocturnal blood pressure drop and adverse reactions were compared between the two groups.Results The ambulatory blood pressure indexes of the two groups after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).After treatment,there were significant differences being found in the comparisons of daytime systolic blood pressure,nighttime systolic blood pressure,daytime diastolic blood pressure and nighttime diastolic blood pressure between the two groups(P<0.05),while there were no statistically significant differences in 24-hour SBP and 24-hour DBP levels(P>0.05).After treatment,the blood pressure variability indexes in the two groups were lower than those before treatment,and those in the night medicine group were lower than the morning medicine group,differences being significant(P<0.05).After treatment,the decrease of nocturnal blood pressure in the two groups was higher than that before treatment,and that in the night medicine group was higher than that in the morning medicine group,the difference being significant(P<0.05).There was no significant difference being found in the comparison of the average heart rate at 24 h after treatment between the two groups(P>0.05).During the treatment,no obvious adverse reactions occurred in the two groups.Conclusion Metoprolol is safe in the treatment of nocturnal hypertension in the elderly,and nighttime administration can better control blood pressure,reduce blood pressure variability,and change the circadian rhythm of blood pressure.