Comparison Of Blood Pressure Changes In Supine-sitting Position In Hypertensive Patients Taking Different Types Of Antihypertensive Drugs

Subject:In fact,the position change of blood pressure should be involved in supine position-sitting position and sitting position-orthostatic postion blood pressure differences.At present,comprehensive existing studies have found that most of the studies are mainly focused on standing Orthostatic hypotension,but the mechanism of sitting hypotension and the change from supine position to sitting position-induced orthostatic hypotension in hypertensive patients undergoing antihypertensive therapy is not yet established.Therefore,in this study,patients with essential hypertension who were taking the same kind of antihypertensive drugs for at least 2 weeks were followed-up in clinical work to investigate the active change from supine position to sitting in patients with essential hypertension by taking different antihypertensive drugs.Methods:1.In this study,taking antihypertensive drugs of high blood pressure in hospital-ized patients were followed in clinical work between March 1,2017 and October 31,2017.According to patients taking different types of antihypertensive drugs,this study included 294 hypertension patients with different antihypertensive drugs included monotherapy ACEI/ARB.monotherapy CCB.combination medication ACEI/ARB+CCB.192 of them were males(65.3%)and 102 females(34.7%);36-85 years of age(63.0±11.2).2.Before BP measurement,patients were asked to take a rest for 10-min in supine position first.Supine BP was measured for 3 times in 1-min interval and their average was recorded as final supine value.Then,the seated BP was measured at 1,2and 3 minute after sitting(Keep the feet touched)· At the same time,the patients' heart rate(HR)values in supine position?seated positions and the patients' symptoms during posture change were recorded.3.Diagnostic Criteria of hypertension : systolic blood pressure above 140mmHgand(or)diastolic blood pressure above 90 mm Hg and excluded secondary hypertens-ion.If patients with previous history of hypertension,are currently taking antihypert-ensive drugs,even if the current blood pressure < 140/90 mm Hg,also diagnosed with high blood pressure[1].4.The criteria for Seated Hypotension were : SBP ?20mm Hg and ?DBP ?10mm Hg by Changing from lying to sitting within 3 minutes[2].5.Measured blood pressure <140/90 mm Hg and 130/80 mm Hg as the patient's blood pressure standard value and calculated the rate of compliance with the three groups(single drug ACEI/ARB group,single drug CCB group,combined treatment ACEI/ARB+CCB group)antihypertensive treatment group.Results:1.Patients' basic situations: 294 cases(192 males)at least take two weeks ant-ihypertensive drugs(ACEI/ARB,CCB,ACEI/ARB plus CCB)of patients with high blood pressure(age 36-85,the average age was 63.0 ± 11.2 years).No significant difference on age,gender distribution and accompanying diseases was found among three groups.2.After statistics:The supine SBP levels were similar among three groups(129.2±16.6 vs 131.7±17.9 vs 130.7±17.4mm Hg,p=0.121>0.05).Although systol-ic blood pressure(SBP)all decreased from supine position to sitting position in patients with essential hypertension who took these three groups of antihypertensive regimens,patients who received antihypertensive therapy in single-agent CCB group had higher rates than the single-agent ACEI/ARB and the combined treatment ACEI/ARB+CCB group observed in patients(6.29±10.41 vs 2.91±11.25 and 1.52± 6.24 mm Hg,p=0.003<0.05)?3.The supine DBP levels in the ACEI/ARB group were slightly lower than the CCB and combination groups(70.3±8.7 vs 72.1±10.8 and 73.0±11.1 mm Hg,p=0.010<0.05).Similar to the systolic blood pressure(SBP)decreased,patients undergoing antihypertensive therapy in the single-agent CCB group had the largest decrease in diastolic blood pressure(DBP)compared with the single-agent ACEI/ARB group and the combined treatment ACEI/ARB+CCB group(2.55±9.21 vs 0.45±5.35 vs 0.15±5.67 mm Hg,p=0.045<0.05).Conclusion:1.In patients with high blood pressure,taking single drug group(CCB)with single drug group(ACEI/ARB)and combined treatment group(ACEI/ARB and CCB),by lying to sitting position change caused by the change in blood pressure is the largest.2.In the hypertensive patients treated with monotherapy or combination of CCB,ACEI and ARB,the prevalence of the SH was 7.5 % for SBP and 11.6% for DBP.Meanwhile,the group with CCB treatment had higher prevalence of the SH as compared with ACEI/ARB.