Efficacy of valsartan hydrochlorothiazide at the different time points on blood pressure variability,carotid intima media thickness,notric oxide and endothelin 1
ZHANG Qianhui;WANG Lili;ZHANG Zhimei;DANG Yi;Heart Center,Hebei General Hospital;
Objective To investigate the efficacy of taking in valsartan hydrochlorothiazide at the different time points on a blood pressure variability( BPV),carotid intima media thickness( CIMT),notric oxide( NO) and endothelin 1( ET-1). Methods Enrolled 80 hypertensive subjects with stage 1 to 2 essential hypertension,who were treated in Hebei general hospital between June 2015 and February 2017. These subjects were randomly assigned to receive valsartan hydrochlorothiazide( 80 mg/12. 5 mg) either on awakening( Ⅰgroup) or at bedtime( Ⅱgroup). All cases received 24 hours ambulatory blood pressure monitoring and CIMT before and after 12 weeks of treatment. NO and ET-1 were monitored before the treatment and12 weeks after the treatment. Results Compared with the baseline level,24 h mean systolic blood pressure( 24 h MSBP),24 h diastolic blood pressure( 24 h MDBP),24 h systolic blood pressure variability( 24 h SBPV),24 h diastolic blood pressure variability( 24 h DBPV),day SBPV,day DBPV,night SBPV,night DBPV,CIMT and ET-1 was dramatically reduced after treatment in both two groups; plasma level of NO was increased in both groups( t_Ⅰ= 8. 61,9. 84,14. 27,12. 84,13. 82,12. 89,12. 35,13. 02,13. 402,13. 573,P 0. 01; t_Ⅱ= 8. 04,10. 35,15. 11,11. 79,14. 86,13. 05,14. 81,14. 23,14. 291,14. 941,P 0. 01); there was no statistically significant difference in CIMT( t_Ⅰ= 0. 262,P_Ⅰ= 0. 414; t_Ⅱ= 0. 145,P_Ⅱ=0. 598). After treatment,there was no statistically significant difference the 24 h MSBP,24 h MDBP,24 h SBPV,24 h DBPV,d SBPV,d DBPV,CIMT,NO and ET-1 between two groups( t = 0. 173,0. 204,1. 832,2. 041,1. 531,1. 394,0. 103,1. 948,1. 630,P 0. 05). Compare with groupⅠ,the night SBPV,night DBPV of groupⅡsignificantly decreased( t = 4. 973,3. 843,P 0. 05). Conclusion The findings confirm that valsartan hydrochlorothiazide taken at the different time points could efficiently reduce blood pressure,24 hours SBPV/DBPV,daytime SBPV/DBPV,plasma level of ET-1,increase plasma level of NO. The improved efficacy in lowering the asleep BPV of hypertensive suggest that valsartan hydrochlorothiazide should be preferably administered at bedtime.
【CateGory Index】： R544.1
【CateGory Index】： R544.1