替米沙坦对中老年非杓型高血压及宽脉压的影响
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摘要
背景与目的 随着生活方式的变化，我国高血压患病率逐年增加。原发性高血压(essential hypertension，EH)的主要危害是导致心脑血管事件，后者是中老年致死致残的主要疾病之一。传统的观念认为，收缩压(systotic blood pressure，SBP)、舒张压(diastolic blood pressure，DBP)、平均动脉压(MAP)显著改变是心血管疾病的危险因子。然而近年来越来越多的研究证据表明，脉压(pulsepressure，PP)增宽是中老年人心脑血管疾病发生和死亡的独立危险因子，其预测作用强于动脉压的收缩压和舒张压。人类的血压变化存在昼夜节律性。夜间血压变化均值比白天下降，大于10％时属生理性波动而称为杓型(dipper)，反之则称为非杓型(non-dipper)。大多数轻-中度高血压患者的血压昼夜波动情况与正常人相似，即夜间血压下降，称为“杓型者”。动态血压监测证实，约15％-20％的原发性高血压患者血压昼夜节律减弱或消失，为非杓型高血压。其与靶器官损伤(HOD)密切相关，已被作为判断高血压严重程度及预后的指标。脉压增宽在预测心血管等靶器官损害方面较收缩压和舒张压更有价值。因此，降压治疗不仅要降低血压，还应按时辰药理学的原理尽可能地纠正紊乱的昼夜节律和宽脉压。替米沙坦为血管紧张素受体阻滞剂(ARB)类药物，大量的药理学及临床研究均证实：其在控制血压及其临床给药时间为一般上午给药。本研究采用晚7时给药的方法，并采用动态血压监测，以观察该变给药时间对中老年非杓型高血压的降压疗效及对血压昼夜节律、脉压、左心室肥厚(LVH)的影响及
Background and Purpose : with the change of life mode, Chinese with hypertension are increasing with years. The main harm of essential hypertension is cardiovascular and cerebrovascular diseases. The latter is one of main reasons for old people to become dead or invalided. The traditional conception thinks systolic blood pressure, diastolic blood pressure and mean arterial pressure are dangerous factors of cardiovascular disease. But recently more and more study show that the increase of pulse pressure is independent dangerous factor of the middle-aged and the old with cardiovascular and cerebrovascular diseases, and its forecast effect is strongly better than systolic blood pressure and diastolic blood pressure. Most patients with light and middle hypertension are similar with normal people in blood pressure
Background and Purpose : with the change of life mode, Chinese with hypertension are increasing with years. The main harm of essential hypertension is cardiovascular and cerebrovascular diseases. The latter is one of main reasons for old people to become dead or invalided. The traditional conception thinks systolic blood pressure, diastolic blood pressure and mean arterial pressure are dangerous factors of cardiovascular disease. But recently more and more study show that the increase of pulse pressure is independent dangerous factor of the middle-aged and the old with cardiovascular and cerebrovascular diseases, and its forecast effect is strongly better than systolic blood pressure and diastolic blood pressure. Most patients with light and middle hypertension are similar with normal people in blood pressure
引文
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