硝苯地平控释片治疗老年性高血压的临床疗效评价

Estimate of Clinical Effect of Nifedipine GITS on Senile Hypertension

目的 观察硝苯地平控释片对老年高血压治疗的临床疗效。方法 本研究采用 2 4h动态血压、超声心动图和平板运动的检查 ,评价硝苯地平控释片对老年高血压患者左室肥厚和运动血压的影响 ,3 6例按WHO标准确诊为老年高血压者 ,排除继发性高血压 ,停降压药 2周后给硝苯地平控释片 ,初始剂量为 3 0mg/d ,晨 8:0 0服 ,1周末有 6例未达显效而增量为 60mg/d治疗 4个月。观察治疗前后 2 4h动态血压 ,超声心动图和平板运动实验结果。结果 硝苯地平控释片治疗后 2 4h收缩压、舒张压及白昼夜间收缩压、舒张压均明显低于治疗前 ;左室质量、室间隔厚度及左室后壁厚度也明显减少 ;治疗后运动高峰时收缩压、运动停止后 3min收缩压亦明显降低。结论 硝苯地平控释片能有效降低老年高血压患者 2 4h收缩压、舒张压 ,逆转左室肥厚 ,并明显降低运动时收缩压 。

Objective To observe the clinical effect of nifedipine GITS on senile hypertension. Methods 24 hour ambulatory blood pressure, ultrasonic cadiogram and treadmill exercise test, were applied in order to estimate the influence of nifedipine GITS on left ventricular hypertrophy (LVH) of 36 patients with senile hypertension. All the patients were diagnosed with hypertension according to the criteria of World Health Organization on the basis of excluding secondary hypertension, and were administered with nifedipine GITS after they had stopped taking drugs for 2 weeks. The patients took nifedipine GITS for 4 months with an initial dosage of 30 mg/d.Results Ambulatory blood pressures of 24 hours, i.e. systolic blood pressure (SBP) and distolic blood pressure (DBP) after therapy, decreased significantly after therapy, so did the SBP at exercise peak and 3 minutes after treadmill exercise test. The left ventricular weight, the thickness of interventricular septum and the left ventricular posterior wall decreased, too.Conclusion It is suggested that nifedipine GITS can clearly decreased 24 hour SBP and DBP, SBP of exercise course, and LVH. But it has no influences on DBP of exercise course, and the circadian rhythms of blood pressure.