Azuma T, Matsubara T, Nagai Y, Funauchi M, Fujimoto T, Saito T, Tone K, Sakoda S
The Second Department of Internal Medicine, The Center for Adult Diseases, Osaka, Japan.
J Hum Hypertens. 1997 Oct;11(10):637-40. doi: 10.1038/sj.jhh.1000446.
To evaluate the effects of antihypertensive agents on the circadian blood pressure (BP) of patients with previous brain infarction, the ambulatory BP was measured non-invasively for 24 h before and after administration of antihypertensive agents. One hundred milligrams of acebutolol twice daily (n = 15) is effective in lowering the BP during the daytime, but has little effect during the night and the morning. Twenty milligrams of slow-release nifedipine twice daily (n = 14) produced a consistent reduction in the BP over the entire 24-h period and effectively blunted the rise in BP in the morning. Captopril (12.5 mg) twice daily (n = 15) produced a mild reduction in BP with little change in the circadian pattern. The slow-release nifedipine group had the greatest decrease in mean systolic and diastolic BP. The heart rate significantly increased after administration of slow-release nifedipine and decreased after administration of acebutolol. To reduce stroke recurrence, we should consider the effects of antihypertensive agents on circadian BP in hypertensive patients with previous brain infarction.
为评估抗高血压药物对既往有脑梗死患者昼夜血压（BP）的影响，在给予抗高血压药物前后，采用无创方法测量患者24小时动态血压。每天两次服用100毫克醋丁洛尔（n = 15）可有效降低白天血压，但对夜间和早晨血压影响较小。每天两次服用20毫克缓释硝苯地平（n = 14）可使24小时内血压持续降低，并有效抑制早晨血压升高。每天两次服用卡托普利（12.5毫克）（n = 15）可使血压轻度降低，昼夜血压模式变化不大。缓释硝苯地平组平均收缩压和舒张压下降幅度最大。服用缓释硝苯地平后心率显著增加，服用醋丁洛尔后心率下降。为降低卒中复发率，我们应考虑抗高血压药物对既往有脑梗死的高血压患者昼夜血压的影响。
