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《Chinese Journal of Difficult and Complicated Cases》 2017-12
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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.
【Fund】: 河北省医学科学研究重点课题(20170006)
【CateGory Index】: R544.1
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