ABSTRACT
Objective To investigate the blood pressure variability(BPV) and circadian rhythms in young and middle-aged people with H-type hypertension.Methods The ambulatory blood pressure monitoring data from 89 young and middle-aged patients with mild-to-moderate hypertension were retrospectively analyzed.All cases were divided into the H-type hypertension group (n=56) and non-H-type hypertension group(n=33) according to plasma homocysteine(Hcy) level.Blood pressure in different time periods(including 24hSBP/24hDBP,dSBP/dDBP,nSBP/nDBP,mSBP/mDBP,mnSBP/mnDBP),variability(including 24hSBPV/24hDBPV,dSBPV/dDBPV,nSBPV/nDBPV,mSBPV/mDBPV,mnSBPV/mnDBPV),day and night average heart rate,dipper ratio of SBP/DBP and morning blood pressure surge were compared between the two group.Results 24hSBP,dSBP,nSBP and mSBP in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group,while 24hDBP,dDBP,nDBP and mDBP were significantly lower than those in the non-H-type group,the differences were statistically significant(P＜0.01).24hSBPV,24hDBPV,dSBPV,nDBPV and mSBPV had statistically significantly difference between the H-type hypertension group and non-H-type hypertension group(P＜0.05).The dipper ratio of SBP and mean MBPS in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group(P＜0.01).Conclusion Blood pressure variability is increased within a certain range in young and middle-aged patients with H-type hypertension,which is correlated to circadian rhythm changes.
ABSTRACT
Objective To explore the effect of combined prescription medication on non-dipper hyperten sive patients.Methods 76 patients with non-dipper hypertensive patients were randomly divided into group A (n =38) and group B (n =38).Telmisartan tablets,hydrochlorothiazide tablets and levamlodipine tablets were given in two groups.Patients in group A take oral medicine at 8 pm,and patients in group B take oral medicine at 8 pm.The levels of plasma angiotensin Ⅱ,plasma endothelin-1 (ET-1),plasma renin,matrix metalloproteinase9 (MMP-9) and Chemerin protein were observed in both groups.Results After treatment,24 h SBP,dSBP and nSBP in group B were significantly lower than those in group A (P ＜ 0.05).The dipper value of group B was significantly higher than that of group A (P ＜ 0.05).The diversion rate of group B was significantly higher than that of group A (P ＜ 0.01).The levels of renin,angiotensin Ⅱ,ET-1,MMP-9 and Chemerin in group B were significantly lower than those in group A at 6 AM and 0:00 (P ＜ 0.05).The degree of change in group B at 0:00 was more significant than that in 6:00 AM (P ＜ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusion The efficacy of telmisartan,hydrochlorothiazide combined with levamlodipine in patients with non-dipper hypertensive patients performs better if patients take medicine at 8 pm other than at 8 pm.