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血压正常者的血压昼夜节律，我们使用了一种新的方法--功率正态变换模型(PNT模型)来研究血压的分布问题。对53例高血压病患者和18例正常血压患者进行了检查。应用ICR5200型动态血压记录仪(ICR5200型动态血压记录仪)，每隔15min无创测量血压，连续24小时。7例高血压病患者服用β-肾上腺素能受体拮抗剂阿替洛尔，每日1次，连续2个月复查。血压正常者18例，其中17例出现明显的血压节律，峰值出现在下午。在高血压患者中，约60%的患者存在与正常血压受试者相同的节律；约60%的患者在下午发现顶峰，20%的患者的血压没有明显的节律。其余20%的患者有明显的节律，但节律的峰相出现在晚上和早晨。高血压病史较长的患者与血压正常的患者有不同节律的趋势。阿替洛尔治疗2个月后，7例患者中有4例血压节律发生改变，2例患者4个月后复查血压节律，节律与治疗前相似，提示高血压患者存在多种血压节律，且血压节律可通过高血压病史和用药改变。

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.