Kuwajima I, Suzuki Y, Kuramoto K, Kawamura H, Otsuka K
Division of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan.
Clin Ther. 1993 Mar-Apr;15(2):338-46.
To determine whether there is an age-related difference in circadian blood pressure changes after administration of a beta-adrenergic blocker, 24-hour ambulatory blood pressure was measured before and after administration of long-acting carteolol, a beta-blocker with intrinsic sympathomimetic activity, in 9 younger and 13 older hypertensive patients. Ambulatory blood pressure was measured noninvasively using an ambulatory blood pressure monitor every 30 minutes for 24 hours before and 8 weeks after a once-daily administration of 15 mg of carteolol. Systolic and diastolic blood pressure in the office significantly decreased in both groups after 8 weeks of carteolol treatment. The whole-day systolic and diastolic blood pressures also fell significantly after carteolol treatment in both groups. Carteolol reduced systolic and diastolic blood pressures during the day in both groups. However, no reduction was observed in nighttime systolic blood pressure in either group, although nighttime diastolic blood pressure tended to decrease in the younger group (P = 0.051). The pulse rate during the night significantly increased in both groups, although no change was observed during the day in either group. We conclude that the antihypertensive effect of carteolol on the circadian blood pressure pattern in younger and older hypertensive patients is comparable. Carteolol reduced only daytime blood pressure while hardly affecting the nighttime blood pressure in both groups.
为了确定服用β-肾上腺素能阻滞剂后昼夜血压变化是否存在年龄相关差异,对9名年轻高血压患者和13名老年高血压患者在服用具有内在拟交感活性的β受体阻滞剂长效卡替洛尔前后进行了24小时动态血压测量。在每天服用15毫克卡替洛尔之前和之后8周,使用动态血压监测仪每30分钟无创测量一次动态血压,持续24小时。卡替洛尔治疗8周后,两组患者的诊室收缩压和舒张压均显著下降。两组患者在卡替洛尔治疗后全天收缩压和舒张压也显著下降。卡替洛尔降低了两组患者白天的收缩压和舒张压。然而,两组患者夜间收缩压均未降低,尽管年轻组夜间舒张压有下降趋势(P = 0.051)。两组患者夜间心率均显著增加,而两组患者白天心率均无变化。我们得出结论,卡替洛尔对年轻和老年高血压患者昼夜血压模式的降压作用相当。卡替洛尔仅降低白天血压,而对两组患者的夜间血压几乎没有影响。