晨起或睡前服用缬沙坦氢氯噻嗪片降压及逆转非杓型高血压的临床比较

发布时间：2018-12-31 19:21

【摘要】：目的探讨晨起或睡前应用缬沙坦氢氯噻嗪片对非杓型高血压患者降压及逆转非杓型高血压的效果。方法纳入74例1~2级非杓型高血压患者,随机分为晨起服药组和睡前服药组,分别在晨起或睡前服用缬沙坦氢氯噻嗪片(每片含缬沙坦80 mg及氢氯噻嗪12.5 mg),所有病例治疗前及治疗12周后进行动态血压监测。结果两组患者治疗后全天各时段血压较治疗前均显著降低(P0.01);治疗后两组间全天及日间平均收缩压、舒张压及血压变异性无显著差异(P0.05);睡前服药组夜间平均收缩压及舒张压显著低于晨起服药组(P0.05);治疗12周后睡前服药组夜间血压降幅较晨起服药组更显著(P0.01);研究结束时,睡前服药组的逆转率显著高于晨起服药组[51%(18/35)vs.8%(3/36),P0.01]。结论晨起和睡前服用缬沙坦氢氯噻嗪片均能够明显降低非杓型原发性高血压患者全天血压;睡前服药能显著降低夜间血压水平,纠正异常血压节律。
[Abstract]:Objective to investigate the effect of valsartan hydrochlorothiazide tablets on lowering blood pressure and reversing non-dipper hypertension in patients with non-dipper hypertension. Methods 74 patients with grade 1 or 2 non dipper hypertension were randomly divided into morning medication group and bedtime medication group. They were treated with valsartan hydrochlorothiazide tablets (each tablet containing valsartan 80 mg and hydrochlorothiazide 12.5 mg),) in the morning or before bedtime. Ambulatory blood pressure monitoring was performed in all patients before treatment and 12 weeks after treatment. Results the blood pressure of the two groups was significantly lower than that before treatment (P0.01), and there was no significant difference in the mean systolic blood pressure, diastolic blood pressure and blood pressure variability between the two groups after treatment (P0.05). The nocturnal mean systolic and diastolic blood pressure were significantly lower in the pre-bedtime group than in the morning group (P0.05), and the nocturnal blood pressure decreased significantly in the pre-bedtime medication group after 12 weeks (P0.01). At the end of the study, the reversal rate was significantly higher in the bedtime group than in the morning group [51% (18 / 35) vs.8% (3 / 36), P0.01]. Conclusion taking valsartan hydrochlorothiazide tablets in the morning and before bedtime can significantly reduce the whole day blood pressure in patients with non-dipper essential hypertension, and before bedtime administration can significantly reduce the level of blood pressure at night and correct abnormal blood pressure rhythm.
【作者单位】：河北省人民医院心脏中心;河北省人民医院内分泌科;
【分类号】：R544.1

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