Stokes G S, Shenfield G M, Johnston H J, Marwood J F, Dunagan F, Boutagy J
Hypertension Unit, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.
J Cardiovasc Pharmacol. 1990;15 Suppl 1:S65-9.
Analysis of an antihypertensive drug trial, which involved measurements of blood pressure (BP) during visits to the clinic at a set time of day, showed that the initial dosage titration procedure had been inadequate in some patients. Plasma drug concentration-time curves and corresponding BP values suggested that control of BP was closely related to plasma drug concentration and that the duration of drug effect was shorter than the dosage interval of 12 h. This interpretation was supported by measurements of BP and drug concentrations taken at steady state, before and 2 h after taking the drug. Measurements of ambulatory BP revealed that some patients whose doses had been titrated at peak plasma drug concentrations had high BP at the time of trough plasma drug concentrations, whereas some of those titrated at trough times were hypotensive at peak times. Adjustment of antihypertensive therapy should entail observations of BP at times coincident with both peak and trough concentrations of the drug concerned, and can be facilitated by ambulatory BP monitoring.
一项抗高血压药物试验分析显示，在一天中特定时间到诊所就诊时测量血压（BP），结果表明初始剂量滴定程序对一些患者并不充分。血浆药物浓度-时间曲线及相应的血压值表明，血压控制与血浆药物浓度密切相关，且药物作用持续时间短于12小时的给药间隔。服药前及服药后2小时稳态时测量的血压和药物浓度支持了这一解释。动态血压测量显示，一些在血浆药物浓度峰值时滴定剂量的患者，在血浆药物浓度谷值时血压较高，而一些在谷值时滴定剂量的患者在峰值时血压偏低。调整抗高血压治疗应包括在相关药物浓度峰值和谷值时同时观察血压，动态血压监测有助于实现这一点。
