不同服药时间对80岁以上高血压患者血压昼夜节律及晨峰现象的影响

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摘要目的探讨不同服药时间对80岁以上高血压患者血压昼夜节律及晨峰现象的影响。方法对入选的2014年6月～2015年6月于我院心内科门诊就诊的80岁以上高血压患者进行动态血压监测，将非杓型血压患者的长效降压药物服用时间由晨起调整为夜间，2周后再次进行动态血压监测，并比较调整前后血压昼夜节律的变化以及对血压晨峰的影响。结果与晨起服药比较，夜间服用长效降压药物对血压的昼夜节律并无显著影响，同时具有同样良好的降压效果（P＞0.05）。与晨起服药比较，睡前服用长效降压药物能有效改善高龄老年患者血压的晨峰现象（P＜0.05），血压晨峰控制率为83%。结论对于高龄老年高血压患者，夜间服用降压长效降压药物同样可以有效地控制血压水平，虽然未能纠正非杓型血压节律，但可以有效控制血压的晨峰现象。

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	马博聪
	赵明

关键词 ：高血压, 昼夜节律, 时间治疗学, 降压药物, 血压晨峰

Abstract：Objective To investigate the influence of differing administration time on blood pressure circadian rhythm and morning blood pressure surge in hypertension patients over 80 years old.Methods The ambulatory blood pressure monitoring was carried out on patients over 80 years old treated in our hospital from June 2014 to June 2015.The dozing-time of long-acting antihypertensive on patients with non-dipper type blood pressure was adjusted from morning to night,and ambulatory blood pressure monitoring was carried out again after 2 weeks.Results Compared with the morning dozing schedule,taking long-acting anti-hypertention drugs at evening having similar BP lowering effect(P＞0.05).In elderly hypertensive patients,taking anti-hypertensive at evening effectively improve the morning blood pressure surge(P＜0.05)and the control rate of morning peak of blood pressure was 83%.Conclusion In hypertension patients over 80 years old,compared with morning dosing schedule,although the circadian rhythm of blood pressure is not significantly changed,taking long-acting anti-hypertensive drugs at evening have similar BP lowering effect,and effectively control the morning blood pressure surge.

Key words： Hypertension Circadian rhythm Chronotherapy Anti-hypertensive drugs Morning blood pressure surge

作者简介: 马博聪（1984-），女，河北医科大学 2017级在读博士研究生（心血管专业），2011至今工作于沧州市中心医院心血管内科，主治医师，研究方向：冠心病、高血压、心衰

引用本文:

马博聪；赵明. 不同服药时间对80岁以上高血压患者血压昼夜节律及晨峰现象的影响[J]. 中国当代医药, 2018, 25(13): 54-56转60.
MA Bo-cong；ZHAO Ming. The influence of differing administration time on blood pressure circadian rhythm and morning blood pressure surge in hypertension patients over 80 years old. 中国当代医药, 2018, 25(13): 54-56转60.

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