Aslan Serkan, Riza Demir Ali, Kahraman Serkan, Memiç Kadriye, Avci Yalçin, Gürbak İsmail, Karabulut Enes, Ertürk Mehmet
Departments of Cardiology.
Pharmacology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital Istanbul, Turkey.
Blood Press Monit. 2020 Aug;25(4):195-200. doi: 10.1097/MBP.0000000000000451.
The influence of the Ramadan fasting on blood pressure (BP) in patients taking diuretics therapy has not been addressed specifically yet. The aim of this study was to examine the effect of long Ramadan fasting on BP with ambulatory BP monitoring in hypertensive patients using diuretics.
This prospective, observational study was done on 129 hypertensive patients and was carried out in two groups: 73 treated hypertensive patients were assigned to the diuretic group and 56 treated hypertensive patients were allocated to the non-diuretic group. Twenty-four-hour ambulatory BP monitoring was performed during and after Ramadan. Mean overall, daytime and nighttime BP were measured and compared in both groups. The differences in mean SBP and DBP were recorded between the two monitoring periods.
In diuretic group, 24-h SBP decreased from 128.2 ± 17.9 to 119.3 ± 9.5 mmHg during Ramadan (8.9 units; P < 0.001). DBP decreased from 79.4 ± 10.9 to 75.3 ± 7.6 mmHg (4.1 units; P < 0.001). On the other hand, SBP and DBP were lower insignificantly in the non-diuretic group. The reduction in SBP was significantly higher in the diuretic group (overall: P = 0.005, daytime: P = 0.011, nighttime: P = 0.022). Thiazide-like diuretics lowered BP more than thiazide-type diuretic despite an insignificant difference.
This study suggested that Ramadan fasting might cause significant reductions in mean SBP and DBP measurements in patients using diuretics. Despite decreasing in BP, diuretics generally well tolerated and can be safe in well-controlled hypertensive patients during Ramadan fasting.
斋月禁食对接受利尿剂治疗的患者血压的影响尚未得到专门研究。本研究的目的是通过动态血压监测，探讨斋月长期禁食对使用利尿剂的高血压患者血压的影响。
本前瞻性观察性研究对129例高血压患者进行，分为两组：73例接受治疗的高血压患者被分配到利尿剂组，56例接受治疗的高血压患者被分配到非利尿剂组。在斋月期间及之后进行24小时动态血压监测。测量并比较两组患者的平均总体、白天和夜间血压。记录两个监测期之间平均收缩压和舒张压的差异。
在利尿剂组中，斋月期间24小时收缩压从128.2±17.9降至119.3±9.5 mmHg（8.9个单位；P<0.001）。舒张压从79.4±10.9降至75.3±7.6 mmHg（4.1个单位；P<0.001）。另一方面，非利尿剂组的收缩压和舒张压略有降低。利尿剂组收缩压的降低显著更高（总体：P=0.005，白天：P=0.011，夜间：P=0.022）。尽管差异不显著，但噻嗪类利尿剂比噻嗪型利尿剂降低血压的效果更明显。
本研究表明，斋月禁食可能会使使用利尿剂的患者平均收缩压和舒张压显著降低。尽管血压下降，但利尿剂通常耐受性良好，在斋月禁食期间，对于血压控制良好的高血压患者可能是安全的。
