摘要
目的探讨高龄非杓型高血压患者睡前给予缬沙坦治疗,血压昼夜节律、血压晨峰现象和血浆肾素-血管紧张素-醛固酮系统(RAAS)活性的变化。方法入选经降压治疗偶测血压正常,24 h动态血压监测昼夜节律为非杓型的高龄老年原发性高血压患者86例,睡前给予口服缬沙坦80 mg,2周后复查24 h动态血压,观察昼夜血压变化、血压晨峰值,并比较干预前后血浆肾素、血管紧张素Ⅱ、醛固酮水平。结果睡前缬沙坦80 mg干预2周后有61.6%患者血压恢复杓型曲线,与干预前比较,干预后的夜间收缩压、夜间舒张压和血压晨峰值明显降低,差异有统计学意义(P=0.009,P=0.043,P=0.003),且血浆肾素、血管紧张素Ⅱ水平显著升高(P=0.001,P=0.002),醛固酮水平明显降低(P=0.004)。结论高龄非杓型高血压患者睡前给予缬沙坦治疗可改善血压昼夜节律的异常,减少血压晨峰现象,抑制RAAS的激活。
Objective To study the effect of valsartan taken before going to bed on circadian rhythm of blood pressure,morning blood pressure peak and activity of plasma rennin-angiotensin- aldosterone system（RAAS） in advance-aged non-dipper hypertension patients. Methods Eighty six advance-aged primary hypertension patients with occasional normal blood pressure after antihypertensive treatment were included in this study. Their circadian rhythm of blood pressure and morning blood pressure peak was monitored two weeks after the patients were treated with oral valsartan（80 rag） before going to bed. Their plasma rennin, angiotensin Ⅱ （Ang Ⅱ ） and aldosterone levels were measured before and after treatment. Results Two weeks after valsartan treatment before going to bed,the dipper hypertension curve was observed in 61.6% of the non-dipper hypertension patients. The night systolic and diastolic blood pressure and morning blood pressure peak were significantly lower after treatment than before treatment（P = 0. 009, P = 0. 043, P = 0. 003）. The plasma rennin and AngⅡ levels were significantly higher（P=0. 001 ,P=0. 002） and the plasma aldosterone level was significantly lower（P=0. 004） in non-dipper patients 2 weeks after valsartan treatment. Conclusion Valsartan taken before going to bed can improve the circadian rhythm of blood pressure,reduce the morning blood pressure peak and inhibit the activation of RAAS in advance-aged non-dipper hypertension patients.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第12期1260-1262,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
