缬沙坦/氨氯地平复方制剂择时用药对非杓型高血压患者血压昼夜节律的影响

被引：39

作者：

栾家杰 ^{[1
]}

刘晓云 ^{[1
]}

张文 ^{[1
]}

许金红 ^{[2
,3
]}

邢文 ^{[1
]}

王安才 ^{[1
]}

宋建国 ^{[2
]}

机构：

[1] 皖南医学院弋矶山医院

[2] 皖南医学院药理教研室

[3] 中国人民解放军海军安庆医院

来源：

中国药理学通报 | 2015年 / 31卷 / 03期

关键词：

氨氯地平; 缬沙坦; 择时用药; 非杓型高血压; 昼夜节律; 余弦曲线;

D O I：

暂无

中图分类号：

R969 [临床药理学];

学科分类号：

100706 [药理学];

摘要：

目的考察昼夜不同时间用药,缬沙坦/氨氯地平复方制剂对非杓型高血压患者降压作用的差异及其对血压昼夜节律的影响。方法非杓型高血压住院患者12例,均衡随机分2组。分别于8∶00及20∶00口服缬沙坦/氨氯地平复方制剂。于用药前及用药后d 3、d 7连续监测患者血压。用药前及用药7 d后取血测定血浆肾素(renin,Ren)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)、内皮素-1(endothelin-1,ET-1)水平。结果非杓型高血压患者的血压呈"昼高夜低、双峰一谷"现象,两峰值分别见于10∶00及18∶00;谷值见于2∶00。但患者昼夜血压差值缩小,杓型值仅为(4.10±1.74)%,呈明显非杓型特征。两时间点用药,均有良好的降压作用,用药后可使收缩压与舒张压的昼、夜均值、24 h均值明显下降(P<0.01)。但20∶00用药对患者夜间血压降低作用较快也较强,能明显改善患者的非杓型血压节律(P<0.01);相反8∶00用药则使非杓型血压节律有加重的倾向。用药7 d后患者血浆Ren、AngⅡ及ET-1水平升高。结论昼夜不同时间用药,缬沙坦/氨氯地平复方制剂对非杓型高血压患者的降压作用无明显差异,但对血压的昼夜节律有显著影响。休息期用药,可使高血压患者非杓型血压节律明显改善。

引用

页码：375 / 381

页数：7

共 14 条

[1]

Effect of azilsartan versus candesartan on morning blood pressure surges in Japanese patients with essential hypertension [J].

Rakugi, Hiromi ;

Kario, Kazuomi ;

Enya, Kazuaki ;

Sugiura, Kenkichi ;

Ikeda, Yoshinori .

BLOOD PRESSURE MONITORING, 2014, 19 (03) :164-169

[2]

Antihypertensive therapy: nocturnal dippers and nondippers. Do we treat them differently?.[J].Chakrapani Mahabala;Unnikrishnan Bhaskaran;Padmanabha Kamath;Aparna U Pai;Narasimha D Pai.Vascular Health and Risk Management.2013, defa

[3]

Circadian clock and cardiovascular disease [J].

Takeda, Norihiko ;

Maemura, Koji .

JOURNAL OF CARDIOLOGY, 2011, 57 (03) :249-256

[4]

PERSPECTIVES ON THE CHRONOTHERAPY OF HYPERTENSION BASED ON THE RESULTS OF THE MAPEC STUDY [J].

Portaluppi, Francesco ;

Smolensky, Michael H. .

CHRONOBIOLOGY INTERNATIONAL, 2010, 27 (08) :1652-1667

[5]

Prevalence and Factors Associated With Circadian Blood Pressure Patterns in Hypertensive Patients [J].

de la Sierra, Alejandro ;

Redon, Josep ;

Banegas, Jose R. ;

Segura, Julian ;

Parati, Gianfranco ;

Gorostidi, Manuel ;

de la Cruz, Juan J. ;

Sobrino, Javier ;

Llisterri, Jose L. ;

Alonso, Javier ;

Vinyoles, Ernest ;

Pallares, Vicente ;

Sarria, Antonio ;

Aranda, Pedro ;

Ruilope, Luis M. .

HYPERTENSION, 2009, 53 (03) :466-U15

[6]

Amlodipine and valsartan as components of a rational and effective fixed-dose combination.[J].Bernard Waeber.Vascular Health and Risk Management.2008, 1

[7]

Responses of vascular smooth muscle cells to estrogen are dependent on balance between ERK and p38 MAPK pathway activities.[J].Bei Cheng;Jian Song;Yun Zou;Qiao Wang;Yueshan Lei;Congli Zhu;Chengjun Hu.International Journal of Cardiology.2008, 3

[8]

Efficacy of the Combination of Amlodipine and Valsartan in Patients With Hypertension Uncontrolled With Previous Monotherapy: The Exforge in Failure After Single Therapy (EX-FAST) Study [J].