ABSTRACT

Objectives: This study was to investigate whether long-term amlodipine-based combination therapy attenuates seasonal variation of office blood pressure (BP) in hypertensive patients. Methods: The data of 206 patients recruited in the Nanchang site of CHIEF trial were retrospectively analyzed. All patients received an amlodipine-based therapy for three years after reaching target BP with a 12-week titration treatment. Among them, 106 patients received amlodipine plus amiloride/hydrochlorothiazide (AA group) and 100 received amlodipine plus telmisartan (AT group) therapies. These patients were followed up every three months . The difference between the highest and lowest values of outdoor temperature in each three months was calculated as the seasonal temperature difference (T-d) and seasonal BP difference was calculated in the similar way. BP control rates in each season were calculated. Results: In the three years, the highest SBP and DBP values occurred in winter and the lowest values in summer. As a result, the BP control rate in summer was the highest and that in winter was the lowest, especially for SBP. Although T-d levels were similar during three following-up years, the seasonal SBP/DBP differences in 2011 were significantly lower than 2009 (10.03 ± 5.74/6.96 ± 3.72 vs 14.36 ± 8.19/9.78 ± 5.21 mmHg, P < .05), suggesting seasonal variation in BP was obviously reduced. Meanwhile, similar change was observed in AA and AT groups. Conclusions: Besides lower BP effectively, long-term amlodipine-based combination therapy could alleviate the seasonal BP variation in high-risk hypertensive patients.

摘要

目的：本研究旨在调查以氨氯地平为基础的长期联合治疗是否能减弱高血压患者诊室血压 (BP) 的季节性变化。方法：对CHIEF试验南昌试验中心招募的206例患者资料进行回顾性分析。所有患者在通过 12 周滴定治疗达到目标血压后接受了三年的氨氯地平治疗。其中，氨氯地平加阿米洛利/氢氯噻嗪（AA组）106例，氨氯地平加替米沙坦（AT组）100例。这些患者每三个月进行一次随访。每三个月室外温度的最高和最低值之间的差异计算为季节性温差（Td）和季节性BP差异以类似方式计算。计算每个季节的血压控制率。结果：三年中，SBP和DBP值最高出现在冬季，最低值出现在夏季。因此，夏季血压控制率最高，冬季最低，尤其是SBP。尽管三个随访年的 Td 水平相似，但 2011 年的季节性 SBP/DBP 差异显着低于 2009 年（10.03 ± 5.74/6.96 ± 3.72 vs 14.36 ± 8.19/9.78 ± 5.21 mmHg，P < .05），表明BP 的季节性变化明显减小。同时，在 AA 和 AT 组中观察到类似的变化。结论：除了有效降低血压外，长期以氨氯地平为基础的联合治疗可以缓解高危高血压患者的季节性血压变化。