长效钙离子拮抗剂对动态血压季节性变异的研究

目的探讨苯磺酸氨氯地平片对动态血压季节性变异的影响。方法 96名轻中度原发性高血压患者随机分为3组,即非洛地平缓释片组（F组）、硝苯地平控释片（X组）和苯磺酸氨氯地平片（A组）,每组32例患者,所有患者用安慰剂洗脱2周后分别给予非洛地平缓释片5mg/d、硝苯地平控释片30mg/d和苯磺酸氨氯地平片5mg/d治疗,1月后血压未达标加用贝那普利片10mg/d。所有患者均于冬季和夏季分别行24小时动态血压监测,观察血压晨峰（MBPS）和冬夏两季血压达标率变化。结果无论24小时、日间还是夜间,冬季A组血压达标率（78.1%,78.1%,75.0%）均明显高于F组（62.5%,65.6%,56.3%）和X组（65.6%,68.8%,65.6%）（均P〈0.01）。冬季A组MBPS（33.7±9.7mmHg）显著低于F组（38.0±11.4mmHg,P〈0.01）和X组（36.9±10.9mmHg,P〈0.05）。结论与非洛地平缓释片和硝苯地平控释片比较,苯磺酸氨氯地平片降低血压季节性变异更明显,冬季24小时动态血压达标率更高。

Effect of long-acting calcium antagonists on seasonal variability of ambulatory blood pressure

Objective To explore the antihypertensive effects of long-acting calcium antagonists on seasonal variability of ambulatory blood pressure. Methods 96 patients with mild-to-moderate essential hypertension were randomly assigned to group F,group X and group A,treated with felodipine extended-release tablet 5mg q. d,nifedipine controlled-release tablet 30 mg q. d and amlodipine besylate tablet 5mg q. d,respectively. One month later,if the blood pressure was over the target,benazepril tablet 10 mg q. d was added. All patients entered the study in the same autumn. 24-h ambulatory blood-pressure monitoring were examined in autumn and summer. The change of the morning blood pressure surge（ MBPS） and the blood pressure control rates were observed. Results In winter,the control rates of 24 hours,daytime or nighttime blood pressure were higher in the group A（ 78. 1%,78. 1%,75. 0%） than both the group F（ 62. 5%,65. 6%,56. 3%） and the group X（ 65. 6%,68. 8%,65. 6%）（ all P〈 0. 01）. Moreover,MBPS of the group A（ 33. 7 ± 9. 7 mmHg） was significantly lower than that of the group F（ 38. 0 ± 11. 4 mmHg,P 〈 0. 01） and the group X（ 36. 9± 10. 9 mmHg,P 〈 0. 05） in winter. Conclusion The amlodipine besylate can help more to lower blood pressure seasonal variability than the felodipine extended-release tablet and the nifedipine controlled-release tablet,which lead to higher 24 hours blood pressure control rate in winter.