控制夜间高血压良方:夜间加用缬沙坦效果佳

2017-06-07 朱柳媛 中国循环杂志

近期,青岛大学医学院徐勤伟等在中国循环杂志发表的一项研究提示,苯磺酸氨氯地平联合缬沙坦夜间给药可有效控制夜间血压水平,改善肾功能,且不增加不良反应。

对夜间高血压早期进行有效干预,是延缓夜间高血压肾功能进一步恶化的关键。

近期,青岛大学医学院徐勤伟等在中国循环杂志发表的一项研究提示,苯磺酸氨氯地平联合缬沙坦夜间给药可有效控制夜间血压水平,改善肾功能,且不增加不良反应。

作者认为,该研究结果“为夜间高血压患者特别是可能伴肾脏靶器官损害的夜间高血压患者提供新的治疗思路,值得在临床中推广。”

作者将87 例服用4 周苯磺酸氨氯地平疗效不佳的夜间高血压患者随机分为两组,在服用氨氯地平的基础上,一组是白天加用缬沙坦(43 例)。另一组是夜间加用缬沙坦(44 例),剂量80~160 mg/次,。

连续治疗8周后,研究发现,夜间服药的患者收缩压和舒张压均明显低于白天给药组,差值分别为16 mmHg和8 mmHg,两组白天SBP和DBP水平则无显着差异。

另外,夜间给药物组患者血清尿素氮(BUN)、血肌酐(Cr)和尿β2- 微球蛋白(β2-MG)水平均低于对照组,估计肾小球滤过率(eGFR)高于对照组。


在不良反应方面,两组比较无明显差异。不良反应包括头痛头晕、胃部不适,症状均较轻,不影响治疗。

研究者指出,夜间给药最担心夜间低血压,但该研究通过对患者动态血压的监测,未发现夜间低血压以及由于血压低导致心脑肾脏器灌注不足的情况。

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    2017-06-07 Y—xianghai

    学习了新知识

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    2017-06-07 wangxy0513

    在不增加不良反应的前提下,血压控制稳定是关键

    0

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    2017-06-07 187****0626

    会不会增进脑梗死风险

    0

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