Effect of blood pressure variability in patients with hypertension treated by amlodipine combined with perindopril / 中国医师进修杂志

ABSTRACT

Objective To observe the effect of blood pressure variability in patients with hypertension treated by amlodipine combined with perindopril.Methods From September 2012 to October 2013,patients with essential hypertension were given amlodipine 5 mg/d for 4 weeks,and 78 patients with blood pressure not reaching the standard after 4 weeks treatment were divided into group A and group B by random number table method,with 39 cases in each.Group A was given amlodipine 10 mg/d,and group B was given perindopril 4 mg/d on this basis (amlodipine 5 mg/d).Twenty-four hour ambulatory blood pressure was monitored in 2 groups by noninvasive portable ambulatory blood pressure monitoring in medication and 8 weeks after medication,measured values of standard deviation and coefficient of variation was used as a measurement of blood pressure variability.Results After 8 weeks of medication plus,24 h systolic blood pressure variability (24 h SSD),systolic blood pressure variability during the day (dSSD),nocturnal systolic blood pressure variability (nSSD),nocturnal systolic blood pressure variation coefficient (nSCV) and 24 h diastolic blood pressure variability(24 h DSD),diastolic blood pressure variability during the day (dDSD),nocturnal diastolic blood pressure variability (nDSD) in group A were significantly lower than those before medication plus[(13.22 ± 1.10) mmHg(1 mmHg =0.133 kPa) vs.(15.97 ± 1.65) mmHg,(12.04 ± 2.21) mmHg vs.(15.15 ±2.89) mmHg,(10.22 ±3.29) mmHg vs.(12.23 ±3.21) mmHg,0.093 ±0.021 vs.0.104 ± 0.017,(11.33 ± 2.09) mmHg vs.(13.27 ± 1.43) mmHg,(10.64 ± 1.81) mmHg vs.(12.57 ± 1.43) mmHg,(9.56 ± 1.32) mmHg vs.(11.23 ± 2.26) mmHg] (P ＜ 0.05),but there were no significant changes among 24 h systolic blood pressure variation coefficient (24 h SCV),systolic blood pressure variation coefficient during the day (dSCV) and 24 h diastolic blood pressure variation coefficient (24 h DCV),diastolic blood pressure variation coefficient during the day (dDCV),nocturnal diastolic blood pressure variation coefficient (nDCV) (P ＞ 0.05).After 8 weeks of medication plus,24 h SSD,24 h SCV,dSSD,dSCV and 24 h DSD,24 hDCV,dDSD,dDCV,nDSD in group B were significandy decreased compared with before combination plus[(10.23 ± 4.72) mmHg vs.(15.27 ± 3.23) mmHg,0.083 ± 0.032 vs.0.106 ± 0.019,(10.85 ± 3.29) mmHg vs.(15.09 ± 3.21) mmHg,0.080 ± 0.028 vs.0.096 ± 0.025,(10.13 ± 2.43) mmHg vs.(13.37 ±3.13) mmHg,0.111 ±0.035 vs.0.136 ±0.032,(9.58 ±2.49) mmHg vs.(12.29 ±3.27) mmHg,0.112 ± 0.036 vs.0.123 ± 0.04 1,(9.46 ± 2.78) mmHg vs.(11.19 ± 4.26) mmHg] (P ＜ 0.05),but there were no significant changes among nSSD,nSCV and nDCV (P ＞ 0.05).After 8 weeks of medication plus,24 h SSD,24 h SCV and 24 h DSD,24 h DCV,dSSD,dDSD,dSCV and dDCV in group B were significantly lower than those in group A (P ＜ 0.05).The nSSD,nDSD,nSCV and nDCV between 2 groups had no significant difference (P ＞ 0.05).Conclusions Amlodipine double dose or amlodipine single dose combined with perindopril can all effectively reduce the 24 hours' systolic and diastolic blood pressure variability,and the combined treatment is better and worthy of further promotion in clinic.