Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, School of Medicine, Tochigi, Japan.
J Clin Hypertens (Greenwich). 2013 Feb;15(2):133-42. doi: 10.1111/jch.12042. Epub 2012 Dec 10.
The Ambulatory Blood Pressure Control and Home Blood Pressure (Morning and Evening) Lowering By N-Channel Blocker Cilnidipine (ACHIEVE-ONE) trial is a large-scale clinical study on blood pressure (BP) and pulse rate (PR) in the real world with use of cilnidipine, a unique L/N-type Ca channel blocker, possessing a suppressive action on increased sympathetic activity in patients with essential hypertension. The effects of cilnidipine on morning hypertension were examined. The authors examined 2319 patients treated with cilnidipine for 12 weeks. Clinic systolic BP (SBP) decreased by 19.6 mm Hg from 155.0 mm Hg, whereas morning SBP decreased by 17.0 mm Hg from 152.9 mm Hg after 12-week cilnidipine treatment. Cilnidipine reduced both morning SBP and PR more markedly in patients with higher baseline morning SBP (-3.2 mm Hg and -1.3 beats per minute in the first quartile of morning SBP, -30.9 mm Hg and -3.2 beats per minute in the fourth quartile), and also reduced both morning PR and SBP more markedly in patients with higher baseline morning PR (0.6 beats per minute and -15.6 mm Hg in <70 beats per minute, and -9.7 beats per minute and -20.2 mm Hg in ≥85 beats per minute). Cilnidipine significantly reduced BP and PR in hypertensive patients at the clinic and at home, especially with higher BP and PR in the morning.
在真实世界中使用独特的 L/N 型钙通道阻滞剂西尼地平来控制血压（BP）和脉搏率（PR）的动态血压控制和家庭血压（早晚）降低（ACHIEVE-ONE）试验是一项大规模的临床研究。该研究考察了西尼地平对晨峰高血压的作用。作者共纳入了 2319 例接受西尼地平治疗 12 周的患者。与基线时的 155.0mmHg 相比，西尼地平治疗 12 周后诊室收缩压（SBP）降低了 19.6mmHg，而晨峰 SBP 则降低了 17.0mmHg。在基线晨峰 SBP 较高的患者中（晨峰 SBP 第 1 四分位数为-3.2mmHg 和-1.3 次/分钟，第 4 四分位数为-30.9mmHg 和-3.2 次/分钟），西尼地平能更显著地降低晨峰 SBP 和 PR；在基线晨峰 PR 较高的患者中（PR＜70 次/分钟时降低 0.6 次/分钟和-15.6mmHg，PR≥85 次/分钟时降低 9.7 次/分钟和-20.2mmHg），西尼地平也能更显著地降低晨峰 PR 和 SBP。西尼地平能显著降低高血压患者的诊室血压和家庭血压，尤其是在清晨血压和脉搏率较高的患者中。
