Fariello R, Boni E, Corda L, Cantalamessa A, Zaninelli A, Pollavini G, Alicandri C, Muiesan G
UOP Scienze Mediche, I Divisione Medica, Spedali Civili, Brescia.
Cardiologia. 1990 Jun;35(6):471-7.
It is not yet known how blood pressure variability contributes to the vascular changes associated with hypertension, but 2 possibly relevant factors are mean blood pressure levels over time and pressure peaks. It has been observed that patients in whom the variability in 24-hour blood pressure is low have a lower prevalence and severity of target organ damage. We carried out a whole-day continuous intraarterial blood pressure recording (Oxford method) in 12 essential hypertensive patients after a 2-week placebo period and after a 4-week felodipine treatment, administered in an extended release formulation, 10 mg once daily at 7 am. Felodipine significantly lowered systolic and diastolic blood pressure values throughout the 24 hours (p less than 0.005 to 0.001). Also, hourly variabilities of systolic and diastolic blood pressure during whole-day monitoring were significantly reduced (p less than 0.05 to 0.001), evaluated on the basis of the hourly means of standard deviation of systolic and diastolic blood pressure. In addition, felodipine significantly lowered the values of blood pressure reached during both dynamic exercise (bicycle ergometer, p less than 0.001) and isometric exercise (handgrip, p less than 0.001).
目前尚不清楚血压变异性如何导致与高血压相关的血管变化，但可能有两个相关因素，即随时间变化的平均血压水平和血压峰值。据观察，24小时血压变异性较低的患者，其靶器官损害的患病率和严重程度也较低。在为期2周的安慰剂期后，以及在接受4周非洛地平治疗后，我们对12例原发性高血压患者进行了全天连续动脉内血压记录（牛津方法）。非洛地平采用缓释制剂，每天上午7点服用10毫克，每日一次。非洛地平在24小时内显著降低了收缩压和舒张压值（p小于0.005至0.001）。此外，根据收缩压和舒张压标准差的每小时均值评估，全天监测期间收缩压和舒张压的每小时变异性也显著降低（p小于0.05至0.001）。此外，非洛地平显著降低了动态运动（自行车测力计，p小于0.001）和等长运动（握力，p小于0.001）期间达到的血压值。
