睡前服用阿司匹林对心血管病高危患者血压昼夜节律的影响:一项随机对照试验。

The impact of acetylsalicylic acid dosed at bedtime on circadian rhythms of blood pressure in the high-risk group of cardiovascular patients-a randomized, controlled trial.

机构信息

Department of Hypertension, Angiology and Internal Diseases, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznań, Poland.

Department of Thoracic And Cardiovascular Surgery/Perioperative diagnostics Bad Oeynhausen, Heart and Diabetes Center NRW, Ruhr-University of Bochum, Bochum, Germany.

出版信息

Eur J Clin Pharmacol. 2021 Jan;77(1):35-43. doi: 10.1007/s00228-020-02997-8. Epub 2020 Sep 21.

Abstract

PURPOSE

Time of drug administration may significantly influence its effect. The aim of the present study was to investigate the effect of ASA (administrated in the morning or in the evening) on the anti-hypertensive effect and diurnal blood pressure profile in the high-risk group of cardiovascular patients.

METHODS

All patients (n = 114) had been diagnosed with coronary heart disease and arterial hypertension prior to the enrolment and had been treated with 75 mg per day of ASA in the morning. The patients were randomly assigned to one of the two study groups receiving 75 mg of ASA per day in a single antiplatelet therapy for 3 months in the morning (n = 58) or in the evening (n = 56). The control group (n = 61) consisted of patients with arterial hypertension but without coronary heart disease, not receiving ASA. In all the patients, during each visit, clinical blood pressure (BP) and ambulatory blood pressure measurements (ABPM) were performed.

RESULTS

There was a significant reduction in 24-h BP and blood pressure at night in the ASA group evening group compared with the ASA morning group and the control group.

CONCLUSIONS

The present study demonstrated that compared with the use of ASA in the morning, its administration in the evening may lead to favourable drop in the ABPM and an improvement of the diurnal profile in the high-risk group of cardiovascular patients who are not naïve to ASA.

摘要

目的

给药时间可能会显著影响药物的疗效。本研究旨在探讨阿司匹林(早上或晚上给药)对心血管高危患者的抗高血压作用和日间血压谱的影响。

方法

所有患者(n=114)在入组前均被诊断为冠心病和动脉高血压,并接受每天 75mg 的阿司匹林治疗。患者被随机分为两组,一组在早上接受每天 75mg 的单药抗血小板治疗(n=58),另一组在晚上接受治疗(n=56),持续 3 个月。对照组(n=61)由未服用阿司匹林的动脉高血压但无冠心病的患者组成。在所有患者中,每次就诊时均进行临床血压(BP)和动态血压测量(ABPM)。

结果

与阿司匹林早上组和对照组相比,晚上组的 24 小时 BP 和夜间血压显著降低。

结论

本研究表明,与早上使用阿司匹林相比,晚上使用阿司匹林可能会导致 ABPM 显著下降,并改善非初治阿司匹林的心血管高危患者的日间血压谱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdf3/7782434/26bd8dec7042/228_2020_2997_Fig1_HTML.jpg

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