晚上和早上的药物对早上的血压激增的影响
Xiao-Jun Zhang1, Yan Yan1, Yan-Jia Liu1
1Department of Medical Science, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Scientific reports
|February 4, 2026
概括
在睡前服用高血压药物可以显著降低早晨的血压激增 (MBPS). 这种睡前给药策略在控制血压尖峰方面比早上给药更有效.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 高血压研究 高血压研究
背景情况:
- 高血压是心血管和脑血管事件的主要危险因素.
- 早晨血压激增 (MBPS) 与脑血管风险增加有关,特别是在老年高血压患者中.
- 了解影响MBPS的因素对于有效的高血压管理至关重要.
研究的目的:
- 为了评估夜间与早晨抗高血压药物管理对早晨血压激增 (MBPS) 的影响.
- 评估不同类型的抗高血压药物在睡前服用时的疗效.
- 为了确定睡前服用药物是否能改善整体血压控制,包括白天心压和夜间心压.
主要方法:
- 对MBPS的8项临床试验和 ambulatory血压计的12项试验进行了系统审查和元分析.
- 包括1239名高血压患者的数据用于MBPS分析和1417名门诊指标.
- 患者在睡前服用药物与早上服用药物的MBPS和其他血压参数的比较.
主要成果:
- 与早晨服用相比,夜间服用药物显著降低了MBPS平均7mmHg.
- 特定的药物类别,如通道阻塞剂和氨酸- ангиотензин- алдостерон抑制剂,在晚上服用时显示出额外的MBPS降低.
- 这些药物与利尿剂的夜间联合使用产生了最大的MBPS降低 (26 mmHg).
- 夜间服用剂量也导致白天静脉缩压 (6 mmHg) 和夜间静脉缩压 (13 mmHg) 的血压降低.
结论:
- 在晚上服用抗高血压药物治疗是控制早晨血压激增 (MBPS) 的更有效策略.
- 在高血压患者中,睡前剂量可以改善夜间血压控制.
- 需要进一步的基于结果的试验来确认这些BP改善是否转化为心血管事件减少.
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