| Subject: The present study try to evaluate postural blood pressure(BP)change in hypertensive patients before and after treatment of nifedipine controlled-release tablet(nifedipine-co).Methods: This clinical trial was followed the Helsinki Declaration(2002)and the drug clinical trial quality management(GCP)strict selection requirements.Fifty-three patients(25M,51.7±9.1Y)with mild-moderate hypertensive participated in the trial were included,diastolic blood pressure(DBP)was between 90 and 109 mm Hg,and systolic blood pressure(SBP)was between 140 and 179 mm Hg in clinic.Blood test,hepatic and renal function,serum lipids,urine pregnancy test(age female),urine and the all ECGs were normal before participating.After two-weeks placebo treatment,the systolic and diastolic blood pressure(SBP/DBP)was still higher than 135/85 mm Hg,and less than 180/110 mm Hg.There were twenty-six patients(12M,52.0±8.7Y)fulfilling the inclusion criteria.Firstly,all patients received nifedipine-co 30mg/d.If the systolic and diastolic blood pressure(SBP/DBP)at office was still higher than 160/100 mm Hg at the end of the 4-weeks treatment,the anti-hypertensive drug dosage increased to 60mg/d in the second 4-weeks.BP and heart rate(HR)were measured in supine,sitting and then standing position(Lying for 10 minutes,sitting for 5 minutes,standing for 3 minutes,each position measured 3 times,each measurement interval of 1 minute)with electronic BP device(Omron-7080-IC)before and after 8-week treatment.Omron-7080-IC is oscillometric machine,with automatic transmission and memory function.The change amplitude of SBP,DBP and HR(?SBP,?DBP and ?HR)between standing-sitting or sitting-supine values was calculated.Continuous variables were expressed as mean ± SD.Two independent sample t-test and the analysis of variance(ANOVA)were used for the statistical analysis.Categorical variables presented as percentage were compared by the Pearson chisquare test.A p-value of less than 0.05 was considered statistically significant.Results: Before the 8 weeks of nifedipine-co antihypertensive therapy,the BP in supine,sitting and standing position was 145.2±14.0/88.5±9.5 mm Hg,145.9±11.4/92.4±7.9 mm Hg and 144.1±11.2/96.2±8.4 mm Hg.Eight-weeks treatment significantly decreased SBP and DBP in three positions.The BP in supine,sitting and then standing position was 131.4±12.6/82.0±9.0 mm Hg,125.6±13.6/80.4±9.7 mm Hg and 128.2±11.4/87.3±7.8 mm Hg respectively.However,the decrease amplitude of sitting SBP(20.3 mm Hg)was larger than the supine and standing SBP(13.8 mm Hg and 15.9 mm Hg,respectively).Similarly,the decrease amplitude of sitting DBP(12.0 mm Hg)was larger than supine and standing DBP(6.5 and 8.9 mm Hg,respectively).Before treatment,the ?SBP in standing-sitting and sitting-supine values was 0.65±10.55 mm Hg and-1.14±10.45 mm Hg respectively;?DBP was 3.85±7.32 and 3.88±5.97 mm Hg.However,after treatment,the SBP and DBP declined(?SBP-5.83±10.90;?DBP-1.55±7.10 mm Hg)in standing-sitting,but increased in the supine-sitting(?SBP 2.62±9.27;?DBP-6.83±6.26 mm Hg).Before treatment,the HR in supine,sitting and standing position was 67.9±8.8 bpm,73.2±9.7 bpm and 77.3±9.6 bpm respectively.After the 8 weeks of nifedipine-co antihypertensive therapy,the values was 72.9±11.3 bpm,78.1±10.4 bpm and 82.9±11.1 bpm.Before treatment the ?HR in standing-sitting and sitting-supine values was 5.30±7.19 and 4.03±5.40 bpm,after the 8 weeks of nifedipine-co antihypertensive therapy the ?HR in standing-sitting and sitting-supine values was 5.25±6.77 and 4.73±4.81 bpm.Conclusion: Before the 8 weeks of nifedipine-co antihypertensive therapy,SBP did not significantly change in the supine-sitting or sitting-standing stage,but DBP and HR gradually increased.In hypertensive patients treated with 8 weeks nifedipine-co,the response of SBP and DBP to the postural change from supine-sitting and sitting-standing was different,decline in the former and increase in the later stage,but the HR changes in the trend of no significant impact. |
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