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目的观察改变给药时间对中老年非杓型高血压的降压疗效及对血压昼夜节律,脉压,左心室肥厚的影响及左心功能参数的变化,以期为临床有效控制血压,恢复昼夜节律提供治疗参考。方法选择在我院内科住院治疗的中老年高血压患者112例,全部进行24h动态血压监测和超声心动图检查对符合非杓型高血压诊断者60例随机分为替米沙坦治疗组和引达帕胺治疗对照组,替米沙坦组30例于下午7时给药80mg,1次/d。引达帕胺组22例于上午7时给药2.5～5mg,1次/d,两组患者分别于治疗前及治疗后12周进行24h动态血压监测和超声心动图检查,观察血压昼夜节律,脉压及左心室参数和左心室质量指数的变化;结果治疗前后夜间血压下降率比较,替米沙坦组优于引达帕胺组,差异有统计学意义(P<0.05),恢复昼夜节律替米沙坦组优于引达帕胺组,替米沙坦组能显著减轻左心室肥厚;结论替米沙坦能明显降压及缩小中老年高血压患者的脉压,可恢复非杓型中老年高血压患者昼夜节律变化规律,明显减少中老年高血压患者左心室肥厚的发生率。
Objective To observe the antihypertensive efficacy and the changes of circadian rhythm, pulse pressure and left ventricular hypertrophy and the changes of left ventricular function parameters in non-dipper hypertensive patients with middle-aged and elderly patients with varied dosing time, in order to effectively control blood pressure and restore circadian rhythm Provide treatment reference. Methods A total of 112 middle-aged and elderly hypertensive patients hospitalized in our department were enrolled in this study. All patients underwent ambulatory 24-h ambulatory blood pressure monitoring and echocardiography. Sixty patients with non-dipper hypertensive were randomly divided into telmisartan group and control group In the control group, 30 patients in the telmisartan group were treated with 80 mg once daily at 7:00 p.m. Twenty-two cases of dopamine group were given 2.5-5mg once daily at 7am, the ambulatory blood pressure monitoring and echocardiography were performed 24 hours before and 12 weeks after treatment. The circadian rhythm of blood pressure, Pulse pressure and left ventricular parameters and left ventricular mass index; Results Before and after treatment, the rate of nocturnal decline in blood pressure, telmisartan group was superior to the induced paramycin group, the difference was statistically significant (P <0.05), to restore circadian rhythm Telmisartan group is superior to the induced Pamine group, Telmisartan group can significantly reduce left ventricular hypertrophy; Conclusion Telmisartan can significantly reduce blood pressure and reduce the pulse pressure in elderly patients with hypertension, non-dipper recoverable The changes of circadian rhythm in middle-aged and elderly hypertensive patients significantly reduce the incidence of left ventricular hypertrophy in middle-aged and elderly hypertensive patients.