INFLUENCE OF METOPROLOL AND CILAZAPRIL ON BLOOD-PRESSURE AND ON SLEEP-APNEA ACTIVITY
INFLUENCE OF METOPROLOL AND CILAZAPRIL ON BLOOD-PRESSURE AND ON SLEEP-APNEA ACTIVITY
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DOI：
10.1097/00005344-199012000-00014
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发表时间：
1990-12-01
影响因子：
3
通讯作者：
PETER, JH
中科院分区：
文献类型：
--
作者：
MAYER, J;WEICHLER, U;PETER, JH
高达50%的高血压男性患有睡眠呼吸暂停（SA）。SA在男性中的患病率高达10%，是一种常见疾病，高血压（HT）是其早期症状之一。重要的是要有一种药物治疗，将有效地控制血压（BP），而不会加剧SA的症状。12例SA和HT患者在一项双盲比较试验中进行了研究。患者被随机分配到美托洛尔（M）100 mg/d或西拉普利（C）2.5 mg/d。在标准化条件下进行多导睡眠图测量，包括动脉内血压监测，在1周治疗前后各连续两晚进行。M组中的值为（平均值±. 95%CI）收缩压161 ±。2.1对比148 .+-。2.2舒张压为98 ± 0.5mmHg（P < 0.01）。1.8对比93 .+-。1.8 mmHg（p < 0.01）; HR 73 . ±. 1.2 vs. 65 .+-. 1.1次/min（P < 0.01）。C组的相应数字为收缩压140 ± 100。2.1对比127 .+-。2.1舒张压为95 ± 0.5mmHg（P < 0.01）。1.7对比78 .+-。1.7 mm Hg（p < 0.02）; HR 82 . ±. 1.1对比79 .+-。1.2次/min（P < 0.01）。而C在所有睡眠阶段都降低了血压和心率，M在REM睡眠期间没有产生变化。在M组中，SA活性为每小时睡眠45次（范围15-91）对34次（范围2-57）呼吸暂停，在C组中为每小时54次（范围21-84）对40次（范围8-72）呼吸暂停（p < 0.01）。总睡眠时间或非快速眼动睡眠与快速眼动睡眠的比例没有变化。M和C都能降低SA患者的夜间血压，但C的效果在所有睡眠阶段都能看到。C对SA患者的夜间血压紊乱有更有利的影响。
Up to 50% of hypertensive men are subject to sleep apnea (SA). With a prevalence in men of up to 10%, SA is a common illness and hypertension (HT) one of its early symptoms. It is important to have available a drug treatment that will effectively control blood pressure (BP) without exacerbating symptoms of SA. Twelve patients with SA and HT were investigated in a double-blind, comparative trial. Patients were randomly allocated to either metoprolol (M) 100 mg daily or cilazapril (C) 2.5 mg daily. Polysomnographic measurements under standardized conditions including intraarterial BP monitoring were taken on two consecutive nights each before and after the 1-week treatment. Values in the M group were (mean .+-. 95% CI) systolic BP 161 .+-. 2.1 vs. 148 .+-. 2.2 mm Hg (p < 0.01); diastolic BP 98 .+-. 1.8 vs. 93 .+-. 1.8 mm Hg (p < 0.01); and HR 73 .+-. 1.2 vs. 65 .+-. 1.1 beats/min (p < 0.01). Corresponding figures for the C group were systolic BP 140 .+-. 2.1 vs. 127 .+-. 2.1 mm Hg (p < 0.01); diastolic BP 95 .+-. 1.7 vs. 78 .+-. 1.7 mm Hg (p < 0.02); and HR 82 .+-. 1.1 vs. 79 .+-. 1.2 beats/min (p < 0.01). Whereas C reduced both BP and HR in all sleep phases, M produced no changes during REM sleep. SA activity was 45 (range 15-91) vs. 34 (range 2-57) apneas per hour of sleep in the M group and 54 (range 21-84) vs. 40 (range 8-72) apneas per hour in the C group (p < 0.01). There were no changes in total sleep time or in the proportions of non-REM to REM sleep. Both M and C reduce nocturnal BP in SA patients, but the effect of C is seen in all sleep phases. C has a more favorable effect on the disturbed nocturnal blood pressure of SA patients.