天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (1): 105-109.doi: 10.11958/58650

• 药物临床观察 • 上一篇    下一篇

不同降压药物联合治疗对老年高血压患者血压变异性的影响

王磊， 魏新伟， 于芳   

  1. 河南省安阳市人民医院心内科 （邮编455000）
  • 收稿日期:2015-03-20 修回日期:2015-08-12 出版日期:2016-01-15 发布日期:2016-01-15
  • 通讯作者: 王磊 E-mail:wanglei_63@163.com
  • 作者简介:王磊(1977)， 男， 主治医师， 主要从事高血压冠心病的诊疗研究

Effects of combined treatment of different anti-hypertensive drugs on blood pressure variability in elderly patients with hypertension

WANG Lei， WEI Xinwei, YU Fang   

  1. Department of Cardiology, The People′s Hospital of Anyang City, Henan 455000, China
  • Received:2015-03-20 Revised:2015-08-12 Published:2016-01-15 Online:2016-01-15

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摘要： 摘要： 目的 比较缬沙坦联合氨氯地平或氢氯噻嗪对老年高血压患者血压变异性的治疗作用。方法 80 例老年高血压患者随机分为 2 组， 分别给予缬沙坦联合氨氯地平 （氨氯地平组） 或缬沙坦联合氢氯噻嗪 （氢氯噻嗪组） 降压治疗， 监测 2 组 24 h 动态血压， 观察治疗前、 治疗第 6 周和第 12 周， 2 组血压及血压变异性的变化。同时观察 2 组 6 周末血压达标率。记录治疗过程中的不良反应情况。结果 2 组治疗 6 周和 12 周的 24 h 平均收缩压 （SBP）、白昼 SBP、 夜间 SBP、 晨峰 SBP、 24 h 收缩压变异性 （SBPV） 均较治疗前降低 （P < 0.05）。24 h SBP、 白昼 SBP、 夜间 SBP、 24 h SBPV 及白昼 SBPV 分组因素与时间因素存在交互作用 （P < 0.05）。治疗第 6 周和第 12 周， 氨氯地平组 24 h SBP、 白昼 SBP、 夜间 SBP 及白昼 SBPV 较氢氯噻嗪组降低 （P < 0.05）， 治疗第 12 周， 氨氯地平组 24 h SBPV 低于氢氯噻嗪组 （P < 0.01）。2 组血压达标率和不良反应发生率差异均无统计学意义。结论 缬沙坦联合氨氯地平或氢氯噻嗪均能有效控制老年高血压患者血压变异性， 而缬沙坦联合氨氯地平在降低血压和血压变异性方面作用更强。

关键词: 高血压, 药物疗法, 联合, 老年人, 缬沙坦, 氨氯地平, 氢氯噻嗪, 血压变异性

Abstract: Abstract： Objective To observe the impacts of valsartan combined with amlodipine or hydrochlorothiazide regimen on blood pressure variability (BPV) in elderly hypertensive patients．Methods Eighty elderly patients with hypertension were randomized into valsartan and amlodipine (the amlodipine group, n=38) or valsartan and hydrochlorothiazide (the hydro⁃ chlorothiazide group， n=37) group．The 24-hour dynamic blood pressure was monitored at baseline, 6-week and 12-week after treatment for the blood pressure and blood pressure variability. The control rate of blood pressure was calculated at 6- week after treatment, and side effects were observed during the treatment．Results Values of 24 h systolic blood pressure (SBP), daytime SBP, nighttime SBP, morning SBP and 24 h systolic blood pressure variability (SBPV) were significantly low⁃ er at 6-week and 12-week than those of baseline in both two groups （P < 0.05). There was an interaction between the group⁃ ing factors and time on 24 h SBP, daytime SBP, nighttime SBP, 24 h SBPV and daytime SBPV (P < 0.05). At the 6 and 12- week treatment, 24 h SBP, daytime SBP, nighttime SBP and daytime SBPV were significantly lower in amlodipine group than those in hydrochlorothiazide group (P < 0.05). At 12-week treatment, 24 h SBPV was significantly lower in amlodipine group than tjat in hydrochlorothiazide group (P < 0.01). There were no significant differences in control rate of blood pressure and side effects between two groups. Conclusion Valsartan in combination with amlodipine or hydrochlorothiazide can both ef⁃ fectively control BPV in elderly hypertensive patients, and valsartan conbined with amlodipine has better effects on lowering blood pressure and BPV．

Key words: Key words: hypertension, drug therapy, combination, aged, Valsartan, Amlodipine, Hydrochlorothiazide, blood pres?sure variability