Chronopharmacology of antihypertensive drugs.

众所周知，昼夜节律存在于一天内的血压波动中。为了研究高血压患者和正常受试者的血压昼夜节律，我们采用了一种新颖的方法，可以面对血压分布的问题，功率-正常转换模型（PNT模型）。对53例高血压患者和18例正常血压患者进行了检查。采用自动袖带充气仪（icr5200动态血压记录仪）无创测量血压，间隔15分钟，持续24小时。7例高血压患者在阿替洛尔治疗前后反复检查，阿替洛尔是一种β肾上腺素能受体拮抗剂，每天1次，连续2个月。在血压正常的受试者中，18人中有17人的血压节律有明显的振幅，并且他们的高潮期出现在下午。在高血压患者中，与正常受试者中发现的节律相同；大约60%的患者在下午出现了高峰期，20%的患者没有明显的血压节律。其余20%的患者有明显的节律，但节律的始发期在晚上和早晨。高血压病史较长的患者与血压正常者有节律不同的趋势。慢性治疗2个月后，7例患者中有4例阿替洛尔改变了血压节律，因此2例患者在4个月后复查，节律与阿替洛尔治疗前发现的节律相似。结论：高血压患者存在一定的血压节律，其节律可通过高血压病史和药物调节。

It is well known that circadian rhythms is found in blood pressure fluctuation within a day. To study the circadian rhythm of blood pressure in hypertensive patients and in normotensive subjects, we used the novel method that can face the problem of the distribution of blood pressure, Power-Normal Transformation model (PNT model). Fiftyty three hypertensive subjects and 18 normotensive subjects were examined. Blood pressure was measured non-invasively by automated cuff inflating device (ICR 5200 Ambulatory Blood Pressure Recorder) with 15 minutes' interval for 24 hours. Seven hypertensive patients were examined repeatedly before and after the treatment of atenolol, a beta adrenergic receptor antagonist, once a day for 2 months.In normotensive subjects, rhythms of blood pressure with significant amplitudes were found in 17 subjects out of 18 and their acrophase were found in the afternoon. In hypertensive patients, the same rhythms as those found in normotensive subjects; acrophase in the afternoon, were found in about 60 % of the patients, and 20 % of the patients had no significant rhythms in their blood pressure. The rest 20 % patients has significant rhythms, but the acrophases of the rhythms were found in the evening and in the morning. There was a tendency that the patient with longer history of hypertension has the different rhythm from that found in normotensive subjects. Atenolol modified the rhythm of blood pressure in 4 partients out of 7 after 2 months' chronic therapy, so 2 patients were reexamined after 4 months, and the rhythms were similar to the rhythms that were found before the atenolol therapy.It is concluded that there are some kinds of blood pressure rhythms in hypertensive patients, and that the rhythm can be modified by the history of hypertension and by the administration of drugs.