The effects of chronotherapy on non-dipper patients with refractory hypertension / 中国基层医药

ABSTRACT

Objective To investigate whether switching anti-hypertensive medication to bedtime could improve blood pressure control in non-dipper patients with refractory arterial hypertension.Methods 30 patients (as observation group) with refractory arterial hypertension and non-dipper pattern on ambulatory blood pressure monitoring were shifted all non-diuretic anti-hypertensive drugs from morning to evening.22 patients with similar characteristics and no changes in the therapeutic regimen formed the control group.Results After 12 weeks treatment,the changes of 24h average systolic/diastolic blood pressure,average diastolic blood pressure during the day and the average diastolic blood pressure at day/nigh were-(2.8 ± 4.2)/-(2.1 ± 3.4)mm Hg,(-1.1 ± 3.1)mm Hg and (-6.3 ±5.9)/(-4.3 ±5.7)mm Hg,respectively.The decrease of mean systolic blood pressure and mean diastolic blood pressure in the observation group were significantly larger than those in the control group(all P ＜0.05).The circadian blood pressure profile changed from non-dipper to dipper in 6 cases in the observation group and no changes were observed in the control group(x2 =4.974,P =0.0263).There was also no difference between two group in terms of untoward reaction.Conclusion In non-dipper patients with refractory arterial hypertension,changing the timing of anti-hypertensive medication to the evening could improve blood pressure control aud help the abnormal circadian blood pressure profile recover to the normal.