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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(P<0.01);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(P>0.05);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(P<0.05);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(P<0.01);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),P<0.01]。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。
Objective To investigate the effect of valsartan hydrochlorothiazide tablet on lowering blood pressure and reversing non-dipper hypertension in patients with non-dipper hypertensive patients. Methods A total of 74 patients with grade 1 or 2 non-dipper hypertension were enrolled in this study. Patients were randomly divided into morning morning medication group and bedtime medication group. Patients were given valsartan hydrochloride hydrochlorothiazide tablets (each containing valsartan 80 mg And hydrochlorothiazide 12.5 mg). All patients were monitored for ambulatory blood pressure before and 12 weeks after treatment. Results After treatment, the blood pressure of the two groups was significantly lower than that before treatment (P <0.01), and the average systolic blood pressure, diastolic blood pressure and blood pressure variability were not significantly different between the two groups after treatment (P> 0.05 (P <0.05). The mean nocturnal systolic blood pressure and diastolic blood pressure at bedtime in medication group were significantly lower than those in morning medication group (P <0.05). At the end of the study, the rate of reversal at bedtime was significantly higher than that in morning morning [51% (18/35) vs.8% (3/36), P <0.01]. Conclusion Both morning and evening bedtime valsartan hydrochlorothiazide tablets can significantly reduce the blood pressure in non-dipper essential hypertension patients. Taking medication before going to bed can significantly reduce nocturnal blood pressure and correct abnormal blood pressure rhythm.