硝苯地平控释片对清晨血压和动态血压季节性变异的影响  

Effect of the nifedipine controlled-release tablet on morning blood pressure and seasonal variability of ambulatory blood pressure

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

机构地区：[1]南昌大学医学院研究生院 [2]江西省人民医院心内科 [3]南昌大学第二附属医院心内科,江西南昌330006

出　　处：《中华高血压杂志》2016年第12期1161-1165,共5页Chinese Journal of Hypertension

基　　金：江西省科技支撑社会发展项目(20151BBG70116)

摘　　要：目的比较硝苯地平控释片和非洛地平缓释片对冬夏两季清晨血压和动态血压达标率的影响。方法入选轻中度原发性高血压患者158例随机分为两组:硝苯地平组(30mg/d,n=79)和非洛地平组(5mg/d,n=79)。所有患者均于2012年秋季纳入试验,治疗至少8周后分别于冬季和夏季均行24h动态血压监测,研究周期为12个月。结果与夏季比较,两组患者冬季24h、日间、夜间平均血压显著增高,清晨血压达标率和动态血压达标率明显降低(均P<0.05);尽管夏季两组血压差异无统计学意义,但硝苯地平组24h平均收缩压、24h平均舒张压、日间平均收缩压以及夜间平均收缩压的冬夏血压差值[(5.5±1.2)、(3.5±1.0)、(4.2±2.2)、(5.6±1.2)mm Hg]明显低于非洛地平组[(9.9±1.3)、(4.7±1.4)、(8.5±1.5)、(7.1±1.2)mm Hg](均P<0.05)。硝苯地平组冬季清晨血压和日间收缩压的变异性[(10.3±4.2)、(8.5±3.2)mm Hg]明显低于非洛地平组[(13.3±4.4)、(10.7±3.9)mm Hg](均P<0.05)。与非洛地平组相比,硝苯地平组能明显提高冬季清晨血压达标率(58.2%比41.8%,P=0.039)和冬季日间血压达标率(60.8%比43.0%,P=0.026)。另外,经多元回归分析发现,降血压药物类别、年龄、体质量指数、季节和吸烟史是影响清晨血压的主要因素。结论与非洛地平缓释片比较,硝苯地平控释片明显降低冬夏血压差值,减少血压波动,提高冬季清晨血压和日间血压达标率。Objective To compare the effects of nifedipine controlled-release tablet with felodipine extended-release tablet on the control rate of morning blood pressure and ambulatory blood pressure of summer and winter. Methods One hundred fifty-eight patients with mild-to-moderate essential hypertension were randomly assigned to group 1or group 2in the autumn of 2012,treated with nifedipine controlled-release tablet 30mg/d（group 1,n=79）or felodipine extended-release tablet 5mg/d（group 2,n=79）,respectively. Eight weeks or more after treatment,24-hour ambulatory blood-pressure monitoring was examined in autumn and summer during the twelve-month period of study. Results The 24-hour,daytime and nighttime mean blood pressure were significantly higher and the control rates of morning blood pressure and ambulatory blood pressure were lower in winter than in summer in the two groups（all P〈0.05）. Although,there was no significant difference of seasonal variability between the two groups,group 1had more significantly lower blood pressure difference between summer and winter of 24-hour mean systolic blood pressure,24-hour mean diastolic blood pressure,daytime mean systolic blood pressure and night mean diastolic blood pressure than group 2[（5.5±1.2）,（3.5±1.0）,（4.2±2.2）,（5.6±1.2）mm Hg vs（9.9±1.3）,（4.7±1.4）,（8.5±1.5）,（7.1±1.2）mm Hg]（all P〈0.05）. In winter,the blood pressure variability of morning blood pressure and daytime blood pressure were significantly lower in group 1 [（10.3±4.2）,（8.5±3.2）mm Hg]than in group 2[（13.3±4.4）,（10.7±3.9）mm Hg,all P〈0.05]. And what is more important,the control rates of morning blood pressure（58.2% vs 41.8%,P=0.039）and daytime blood pressure（60.8% vs43.0%,P=0.026）in winter were significantly higher in group 1. Additionally,multivariate regression analysis showed the category of the blood pressure medication,age,body mass index,season and smoking were the main factors influencing morning blood pressure. Conclusions

关 键 词：钙拮抗剂 动态血压监测 清晨血压 季节性 

分 类 号：R544.1[医药卫生—心血管疾病]