Department of Cardiology, China-Japan Friendship Hospital, Beijing, China.
Eur Rev Med Pharmacol Sci. 2012 May;16(5):653-9.
To investigate the morning blood pressure surge (MBPS) in Chinese patients with mild to moderate essential hypertension treated with long-term administration of olmesartan, an angiotensin II receptor antagonist according to ambulatory blood pressure monitoring (ABPM).
In a multi-center, prospective study, we investigated the long-term efficacy of olmesartan by ABPM in 18-75 years-old Chinese patients with mild to moderate hypertension (clinic diastolic blood pressure [DBP] 90-109 mm Hg and systolic blood pressure [SBP] < 180 mmHg). After a 1 week placebo runin, 87 patients were treated with olmesartan 20 mg once daily in the morning for 24 weeks. Ambulatory blood pressure monitoring was conducted at baseline and at the end of 24 weeks. At baseline, patients with an MBPS > or = 23 mmHg were classified as the MBPS group (n = 41), and all other patients were classified as the non-MBPS group (n = 46).
The mean systolic and diastolic blood pressures (SBP/DBP) over 24 hours were reduced from 141.78 +/- 12.8/91.17 +/- 7.34 to 128.35 +/- 15.86/83.58 +/- 9.53 mmHg (p < 0.01). The mean blood pressure in the final 6 hours of the dosing interval dropped from 135.75 +/- 5.84/87.29 +/- 4.80 mmHg to 122.98 +/- 6.46/80.49 +/- 4.31 mmHg (p < 0.01). The MBPS for SBP/ DBP were reduced from 35.68 +/- 8.85/29.77 +/- 17.19 mmHg to 28.62 +/- 15.08/19.08 +/- 11.01 mmHg in the MBPS group (p < 0.05). The reductions in MBPS after treament with olmesartan were significantly different between the two groups (p < 0.01).
Olmesartan effectively reduces blood pressure in patients with essential hypertension, and olmesartan especially reduces the MBPS in MBPS-prone patients.
通过动态血压监测(ABPM)研究长期应用血管紧张素Ⅱ受体拮抗剂奥美沙坦治疗的轻中度原发性高血压患者的清晨血压激增(MBPS)。
在一项多中心、前瞻性研究中,我们通过 ABPM 研究了奥美沙坦对 18-75 岁轻中度高血压患者(诊室舒张压 [DBP] 90-109mmHg 和收缩压 [SBP] <180mmHg)的长期疗效。经过 1 周的安慰剂洗脱期后,87 例患者每日清晨服用奥美沙坦 20mg,共 24 周。在基线和 24 周时进行 ABPM。基线时,MBPS >或=23mmHg 的患者被分为 MBPS 组(n=41),其余所有患者被分为非 MBPS 组(n=46)。
24 小时平均收缩压和舒张压(SBP/DBP)从 141.78+/-12.8/91.17+/-7.34mmHg 降至 128.35+/-15.86/83.58+/-9.53mmHg(p<0.01)。给药间隔最后 6 小时的平均血压从 135.75+/-5.84/87.29+/-4.80mmHg 降至 122.98+/-6.46/80.49+/-4.31mmHg(p<0.01)。MBPS 组的 SBP/DBP 从 35.68+/-8.85/29.77+/-17.19mmHg 降至 28.62+/-15.08/19.08+/-11.01mmHg(p<0.05)。两组间奥美沙坦治疗后的 MBPS 降低差异有统计学意义(p<0.01)。
奥美沙坦能有效降低原发性高血压患者的血压,尤其能降低 MBPS 倾向患者的 MBPS。