Wu H, Zhang Y, Huang J, Zhang Y, Liu G, Sun N, Yu Z, Zhou Y
Division of Hypertension, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing.
Hypertens Res. 2001 Sep;24(5):605-10. doi: 10.1291/hypres.24.605.
To compare the effects of an alpha, beta blocker, arotinolol, in the treatment of essential hypertension between patients with a dipper and those with a non-dipper profile by means of 24-h ambulatory blood pressure monitoring (ABPM), a multicenter single blind parallel trial was carried out in five clinical centers. After a one-week single blind placebo run-in period, the patients underwent ABPM if their clinic diastolic blood pressure (DBP) ranged from 90-109 mmHg and their clinic systolic blood pressure (SBP) was <180 mmHg. They were divided into two groups according to the absence (non-dipper group, 24 cases) or presence (dipper group, 23 cases) of nocturnal BP reduction > or =10% of daytime BP. ABPM was measured again at the end of the active treatment phase. All patients were given Arotinolol 10-20 mg twice daily for 4 weeks. Twenty four-hour systolic and diastolic average BPs (MSBP, MDBP), 24-h systolic and diastolic blood pressure load (LS BP, LDBP), daytime systolic and diastolic average BPs (dMSBP, dMDBP), daytime systolic and diastolic blood pressure load (dLSBP, dLDBP), nighttime systolic and diastolic average BPs (nMSBP, nMDBP) and nighttime systolic and diastolic blood pressure load (nLSBP, nLDBP) were calculated. Arotinolol was effective in 78.2% of dippers and 54.2% of non-dippers, but the difference in effectiveness between these groups was not statistically significant. After treatment, SBP and DBP-including 24-h, daytime and nighttime systolic and diastolic BPs- were significantly reduced in both groups. During the daytime period, the systolic and diastolic blood pressures were significantly reduced in both dippers and non-dippers, while nighttime systolic and diastolic blood pressures were significantly reduced only in the non-dipper group. No significant changes were found in the dipper group over this period. In conclusion, Arotinolol, which can be dosed twice daily, is an effective antihypertensive agent which effectively lowers blood pressure during the day while reducing nighttime blood pressure more in non-dippers than in dippers, without excessive lowering blood pressure in the latter.
为通过24小时动态血压监测（ABPM）比较α、β受体阻滞剂阿罗洛尔治疗杓型和非杓型原发性高血压患者的效果，在五个临床中心开展了一项多中心单盲平行试验。经过为期一周的单盲安慰剂导入期后，若患者诊室舒张压（DBP）在90 - 109 mmHg之间且诊室收缩压（SBP）<180 mmHg，则进行ABPM。根据夜间血压下降幅度是否≥日间血压的10%，将患者分为两组（无夜间血压下降组即非杓型组，24例；有夜间血压下降组即杓型组，23例）。在积极治疗阶段结束时再次测量ABPM。所有患者均给予阿罗洛尔10 - 20 mg，每日两次，共4周。计算24小时收缩压和舒张压平均血压（MSBP、MDBP）、24小时收缩压和舒张压血压负荷（LS BP、LDBP）、日间收缩压和舒张压平均血压（dMSBP、dMDBP）、日间收缩压和舒张压血压负荷（dLSBP、dLDBP）、夜间收缩压和舒张压平均血压（nMSBP、nMDBP）以及夜间收缩压和舒张压血压负荷（nLSBP、nLDBP）。阿罗洛尔对78.2%的杓型患者和54.2%的非杓型患者有效，但两组间有效性差异无统计学意义。治疗后，两组的SBP和DBP（包括24小时、日间和夜间收缩压和舒张压）均显著降低。在白天时段，杓型和非杓型患者的收缩压和舒张压均显著降低，而夜间收缩压和舒张压仅在非杓型组显著降低。在此期间，杓型组未发现显著变化。总之，阿罗洛尔每日给药两次，是一种有效的抗高血压药物，可有效降低日间血压，且相比杓型患者，对非杓型患者夜间血压降低更多，同时不会使后者血压过度降低。
