Prattichizzo F A, Galetta F
I Divisione di Medicina Interna, Ospedale di San Miniato, Pisa.
Minerva Cardioangiol. 1993 Dec;41(12):587-90.
One of the functions of the sympathetic nervous system is to produce a short-term increase in blood pressure. It might be thought, therefore, that antihypertensive drugs which interfere with the functioning of the sympathetic nervous system (e.g. betablockers) would reduce blood pressure variability over 24 h whereas those that act independently of it (e.g. ACE inhibitors) would not. Two groups of 10 hypertensives underwent noninvasive 24-h blood pressure monitoring before and after antihypertensive treatment with a betablocker (atenolol) and an ACE inhibitor (benazepril) respectively. Blood pressure variability was measured by the variability coefficient (standard deviation/mean). Atenolol induced a non-statistically significant decrease in blood pressure variability, whereas benazepril caused a statistically significant increase in systolic blood pressure variability. Therefore, we conclude that the evaluation of ACE-inhibitor therapeutic effect on blood pressure by the "casual" measurement can be misleading in judging the efficacy of such drugs.
交感神经系统的功能之一是使血压短期内升高。因此可能会认为，干扰交感神经系统功能的抗高血压药物（如β受体阻滞剂）会降低24小时内的血压变异性，而那些独立于交感神经系统起作用的药物（如ACE抑制剂）则不会。两组各10名高血压患者分别接受β受体阻滞剂（阿替洛尔）和ACE抑制剂（贝那普利）抗高血压治疗前后进行了24小时无创血压监测。通过变异系数（标准差/均值）测量血压变异性。阿替洛尔使血压变异性出现非统计学显著降低，而贝那普利使收缩压变异性出现统计学显著升高。因此，我们得出结论，通过“偶然”测量评估ACE抑制剂对血压的治疗效果，在判断此类药物疗效时可能会产生误导。
