Impacts Of Anti-hypertensive Agents On Blood Pressure Variability In Hypertensive Patients

Objective: To investigate the effects of visit-to-vist blood pressure variability（BPV） and24h ambulatory BPV in patients with essential hypertension,whoes were treated withNifedipine GITS,Losartan,Perindopril and these dugs combination with hydrochlorothiazide(HCT), respectively. Aims to provide new evidence to support when clinical doctors choosedifferent anti-hypertensive drugs.Materials and Methods: Having collected152examples among cardiovascularDepartmentof the affiliated hospital of medical school of Ningbo University,from July2011to February2013.They all matched the conditions.Then patients are randomly treated with theNifedipineGITS (30mg/d)or Losartan(100mg/d)or Perindopril(4mg/d),and all of them weretreated for8weeks.During the test,patients should been diagnosed every2weeks,aimly toobserve the blood pressure. If blood pressure goal has not been attained after2week’streatment,they will take12.5mg/d HCT additionally. Before and after the8weekstreatment,all patients would do the24h ambulatory blood pressuremonitoring(ABPM),recording the dates of ABPM.Statistical methods:All dates analysised by statistics software SPSS17.0,and themeasurement dates were expressed by mean±standard deviationg（x s）,enumeration dateswere expressed by percentage (%).The baseline information of the patients from differtentgroup analysised with variance,and the difference between groups analysised in the sameway,while the difference of after the treatment in each group will analysis with independent-samples T Test.P<0.05has statistically significant.Results:1. The indexs of patients we collected have no statistical difference in each group(P>0.05).2. The dates of visit-to-visit blood pressure in each group are lower when after thetreatment,the differences are statistically significant(P<0.05).Nifedipine GITS can effectly reducethe visit-to-visit systolic blood pressure(SBP) and systolic blood pressure variability(SBPV).And ithas effective effect to diastolic blood pressure variability(DBPV).While Losartan can reduce the visit-to-visit SBPV and DBPV.In addition, Perindopril has no significant effect on visit-to-visitSBPV. Three groups of drug combination with HCT have the similar influence trend to visit-to-visit BP/BPV,when compeared with single dug.Nifedipine GITS combination with HCT isbetter than Nifedipine GITS in reducing visit-to-visit BPV after the treatment,the differencehas statistical significance（P<0.05）.3. The dates of24h BP in each group are lower when after the treatment(P<0.05).Nifedipine GITS can effectly reduce the SBP,especially to reducing nSBP. Losartan caneffectly reduce the dSBP.In addition, three groups have no significant effect on nDBP.Threegroups of drug combination with HCT have the similar influence trend to24h BP/BPV whencompeared with single dug.Nifedipine GITS combination with HCT is better than NifedipineGITS in reducing24hSBP after the treatment(P<0.05)4.N ifedipine GITS can effectly reduce the SBPV,especially to reducing nSBPV. Losartan caneffectly reduce24SBPV/dSBPV. Perindopril has no significant effect on BPV(P>0.05).Inaddition, three groups of drug combination with HCT have the similar influence trend to24hBPV when compeared with single dug.Conclusions:N ifedipine,Losartan and Perindopril all can reduce visit-to-visit BP and24h BP,but havedifference between visit-to-visit BPV and24hBPV.Also three of them can have different effectsfor different periods.Combining with HCT are better than single drug in reducing BP and BPV.Theeffect of every group to visit-to-visit BPV and24hBPV is independent of the effct of BP.