氨氯地平和贝那普利对老年高血压患者清晨血压季节性变异的对比研究  

Effect of amlodipine and benazepril on seasonal variability of morning blood pressure in elderly hypertensive patients

作　　者：曹平良[1,2] 程晓曙[3] 李年娥[4] 唐琼珍[4] 陈早芳[4] 

机构地区：[1]南昌大学医学院,330006 [2]江西省人民医院 [3]南昌大学第二附属医院心血管内科 [4]江西省人民医院老年心血管科

出　　处：《中华老年心脑血管病杂志》2016年第12期1251-1254,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：江西省科技计划项目(20151BBG70116)

摘　　要：目的比较苯磺酸氨氯地平和盐酸贝那普利对老年轻中度原发性高血压患者清晨血压季节性变异的影响。方法选择轻中度原发性高血压患者105例,随机分为氨氯地平组53例和贝那普利组52例。所有患者均于2012年秋季纳入试验,治疗至少4周后分别于春夏秋冬四季行24h动态血压监测,每月至少测量诊室血压2次,同时记录当日平均气温、日照时间和相对湿度,共观察12个月。结果 2组冬秋两季清晨血压均明显高于春夏两季,差异有统计学意义(P<0.05,P<0.01)。氨氯地平组冬季清晨血压明显低于贝那普利组[(134.2±4.5)mm Hg vs(139.4±4.6)mm Hg,1mm Hg=0.133kPa,P<0.05],冬季清晨血压达标率明显高于贝那普利组(49.1%vs28.8%,P<0.05)。多元回归分析显示,降压药物类别、冬季、日照时间、秋季和体质量指数是影响清晨血压的主要因素。结论老年原发性高血压患者清晨血压存在明显的冬秋两季增高现象;氨氯地平较贝那普利能明显提高冬季清晨血压达标率。Objective To compare the effect of amlodipine and benazipril on seasonal variability of morning blood pres,;ure in elderly patients with mild-moderate primary hypertension. Methods One hundred and five patients with mild-moderate primary hypertension were randomly divided into amlodipine treatment group （n=53） and benazipril treatment group （n=52）. Their 24 h am-bulatory blood pressure （ABP） was measured in spring, summer, autumn and winter after 4 weeks of treatment and office blood pressure was measured twice at least each month. Their average daily temperature,sunshine time and relative humidity were recorded for 12 months. Results The morning blood pressure of the two groups was significantly higher in winter and autumn than in summer and spring （P〈0.05,P〈0.01）. The morning blood pressure in winter was significantly lower whereas its control rate in winter was significantly higher in amlodipine treatment group than in benazipril treatment group （134.2±4.5 mm Hg vs 139.4±4.6 mm Hg,P〈0.05;49. 1% vs 28.8% ,P〈0. 05）. Multivariate regression analysis showed that antihypertensive agents, winter, sunshine time,autumn and BMI were the major influencing factors for morning blood pressure. Conclusion The morning blood pressure of elderly patients with primary hypertension is higher in winter and autumn than in spring and summer. The effect of amlodipine is better than that of benazepril in controlling morning blood pressure in winter.

关 键 词：氨氯地平 高血压 血压监测 便携式 季节 

分 类 号：R544.1[医药卫生—心血管疾病]