Xia Jia-Hui, Cheng Yi-Bang, Xu Ting-Yan, Guo Qian-Hui, Chan Chak-Ming, Hu Lei-Xiao, Li Yan, Wang Ji-Guang
Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Blood Press Monit. 2025 Apr 1;30(2):73-81. doi: 10.1097/MBP.0000000000000736. Epub 2024 Nov 26.
The objective of this study was to investigate the efficacy of the nitrendipine/atenolol combination in comparison with standard-dose nitrendipine or atenolol monotherapy in reducing blood pressure (BP) and blood pressure variability (BPV) as assessed by ambulatory BP monitoring.
In a randomized, crossover trial, 32 patients (30-65 years) with grade 1 hypertension and elevated daytime reading-to-reading BPV were randomly assigned to receive either the nitrendipine/atenolol combination (10/20 mg) or standard-dose nitrendipine (10 mg) or atenolol (25 mg) monotherapy for 6 weeks, followed by a crossover to another treatment for 6 weeks.
The final analysis included 31 patients (mean [±SD] age, 49.2 ± 9.6 years) and 12 men. The nitrendipine/atenolol combination significantly reduced from baseline clinic and ambulatory BP and pulse rate ( P ≤ 0.002), and 24 h and daytime systolic and diastolic BPV as assessed by SD and average real variability ( P ≤ 0.042), but not the coefficient of variation nor nighttime BPV indices ( P ≥ 0.06). Significant differences between the nitrendipine/atenolol combination and nitrendipine or atenolol monotherapy at the end of treatment were observed in clinic BP and pulse rate ( P ≤ 0.042), but not in 24 h, daytime and nighttime blood pressure and pulse rate, except for daytime DBP and 24 h and daytime pulse rate ( P ≤ 0.049). There were no significant differences in BPV between the combination and monotherpy groups at the end of treatment ( P ≥ 0.25).
The nitrendipine/atenolol combination reduced daytime reading-to-reading BPV, but did not show superiority to nitrendipine or atenolol monotherapy.
本研究的目的是通过动态血压监测评估，比较尼群地平/阿替洛尔联合用药与标准剂量尼群地平或阿替洛尔单药治疗在降低血压（BP）和血压变异性（BPV）方面的疗效。
在一项随机交叉试验中，32例年龄在30 - 65岁之间的1级高血压且日间逐次读数BPV升高的患者被随机分配接受尼群地平/阿替洛尔联合用药（10/20mg）或标准剂量尼群地平（10mg）或阿替洛尔（25mg）单药治疗6周，随后交叉接受另一种治疗6周。
最终分析纳入31例患者（平均[±标准差]年龄，49.2±9.6岁），其中男性12例。尼群地平/阿替洛尔联合用药使诊所血压、动态血压和脉搏率较基线显著降低（P≤0.002），并且通过标准差和平均实际变异性评估的24小时及日间收缩压和舒张压BPV显著降低（P≤0.042），但变异系数和夜间BPV指数未降低（P≥0.06）。在治疗结束时，观察到尼群地平/阿替洛尔联合用药与尼群地平或阿替洛尔单药治疗在诊所血压和脉搏率方面存在显著差异（P≤0.042），但在24小时、日间和夜间血压及脉搏率方面无显著差异，除了日间舒张压以及24小时和日间脉搏率（P≤0.049）。治疗结束时联合用药组与单药治疗组在BPV方面无显著差异（P≥0.25）。
尼群地平/阿替洛尔联合用药降低了日间逐次读数BPV，但未显示出优于尼群地平或阿替洛尔单药治疗的效果。
