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目的探讨不同时间服用氨氯地平对非杓型高血压患者血压昼夜节律的影响。方法经动态血压监测,选取非杓型高血压患者84例,随机分为两组:晨起服药组(n=42)和睡前服药组(n=42),分别于7:00～9:00和20:00～22:00服用氨氯地平5mg,连续治疗12周。给药前后分别进行动态血压监测,观察晨起服药组和睡前服药对非杓型高血压患者昼夜血压节律的影响。结果晨起服药组与睡前服药组在治疗后24h平均收缩压及舒张压均明显降低(P<0.05),与晨起服药组相比睡前服药组夜间收缩压和舒张压明显下降(P<0.05),睡前服药组对非杓型高血压的血压模式明显改善,两组有效率分别为16.7%和47.6%(P<0.01)。结论对非杓型高血压患者采取睡前服用氨氯地平不但可以有效降低血压,还可以改善异常的血压昼夜节律,从而更好地保护靶器官。
Objective To investigate the effect of amlodipine at different times on the blood pressure circadian rhythm in non-dipper hypertensive patients. Methods Eighty-four patients with non-dipper hypertensive were enrolled in this study. They were randomly divided into early morning medication group (n = 42) and bedtime medication group (n = 42) 00 and 20: 00 ~ 22: 00 amlodipine 5mg, continuous treatment for 12 weeks. Before and after administration of ambulatory blood pressure monitoring were observed early morning medication and bedtime medication on diurnal blood pressure rhythm of non-dipper hypertensive patients. Results The systolic blood pressure and diastolic blood pressure were significantly lower at early onset and at bedtime (P <0.05), and the systolic and diastolic pressure at bedtime were significantly lower than those in the early morning group (P <0.05). The blood pressure pattern of non-dipper hypertension was significantly improved at bedtime in the medication group, with the effective rates of 16.7% and 47.6% (P <0.01). Conclusion Taking amlodipine at bedtime before non-dipper hypertensive patients not only can effectively reduce blood pressure, but also can improve the circadian rhythm of abnormal blood pressure, so as to better protect the target organ.