Portaluppi F, degli Uberti E, Strozzi C, Margutti A, Montanari L, Rambaldi R, Trasforini G, Pansini R
Acta Cardiol. 1987;42(1):37-47.
The aim of this study was to investigate the effect of orally administered, slow-release, nifedipine tablets on the circadian rhythm of blood pressure and heart rate, in hospital patients with clinical diagnosis of hypertension validated by a chronobiologic inferential statistic method. A group of 14 patients (nine women and five men, 47 to 71 years old) with clinical diagnosis of "essential hypertension" underwent automatic blood pressure and heart rate monitoring in a hospital room for 48 hours. Measurements were taken every 15 min by an oscillometric instrument with automatically inflated cuff. The patients received no treatment during the two proceeding weeks and the first day of the study. On the second day, slow-release nifedipine tablets were administered, one at 10 a.m. and one at 10 p.m. A highly significant circadian rhythm was documented for systolic and diastolic blood pressure, mean arterial pressure and heart rate, both in basal conditions and after nifedipine. Blood pressure mesors were higher than reference standards in basal conditions, and were lowered (average decrease = 20 mmHg for systolic and 9 mmHg for diastolic mesor) by nifedipine. A significant, though minor, elevation of heart rate mesor (from 70 to 75 b.p.m.) was also noted during treatment. The circadian amplitudes of blood pressure and heart rate did not differ significantly before and during treatment. In conclusion, the circadian rhythm of blood pressure is still present with the same amplitude after slow-release nifedipine, but is set at a lower pressure level. Heart rate rhythm is also preserved, with only a minor elevation of its mesor.
本研究旨在通过一种时间生物学推断统计方法，调查口服缓释硝苯地平片对临床诊断为高血压的住院患者血压和心率昼夜节律的影响。一组14例临床诊断为“原发性高血压”的患者（9名女性和5名男性，年龄47至71岁）在医院病房接受了48小时的自动血压和心率监测。每15分钟通过带自动充气袖带的示波测量仪进行测量。在研究的前两周和第一天，患者未接受治疗。第二天，口服缓释硝苯地平片，上午10点服用一片，晚上10点服用一片。无论是在基础状态还是服用硝苯地平后，收缩压、舒张压、平均动脉压和心率均呈现出高度显著的昼夜节律。基础状态下血压中值高于参考标准，硝苯地平使其降低（收缩压中值平均降低20 mmHg，舒张压中值平均降低9 mmHg）。治疗期间还观察到心率中值有显著但轻微的升高（从70次/分钟升至75次/分钟）。治疗前和治疗期间血压和心率的昼夜波动幅度无显著差异。总之，服用缓释硝苯地平后，血压的昼夜节律仍然存在，幅度相同，但处于较低的血压水平。心率节律也得以保留，只是其中值略有升高。
