Effects of different doses of atorvastatin combined with valsartan on blood pressure variability and circadian rhythm in patients with hypertension
10.3760/cma.j.cn115455-20200224-00176
- VernacularTitle:不同剂量阿托伐他汀联合缬沙坦对高血压患者血压变异性及昼夜节律的影响
- Author:
Lei LI
1
;
Gendong ZHOU
;
Sheng LI
;
Peng CHENG
;
Yibao SHI
;
Yongsheng WANG
;
Xiaohong ZHANG
Author Information
1. 合肥市第一人民医院心血管内科 230061
- From:
Chinese Journal of Postgraduates of Medicine
2020;43(6):540-544
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the effects of different doses of atorvastatin combined with valsartan on blood pressure variability (BPV) and circadian rhythm in patients with hypertension.Methods:Eighty patients with grade 2 and grade 3 hypertension from March 2018 to March 2019 in Hefei First People′s Hospital were divided into low-dose group (20 mg/d atorvastatin combined with valsartan) and high-dose group (40 mg/d atorvastatin combined with valsartan) according to the random number table method. The efficacy after 8 weeks of treatment was compared between the two groups. The BPV, circadian rhythm, vascular endothelial factors [nitric oxide (NO), endothelin (ET)], serum disease-related factors [human cartilage glycoprotein (YKL-40), soluble intercellular adhesion molecule-1(sICAM-1), folate] and blood lipids [total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] were recorded before treatment and 8 weeks after treatment, and the occurrence of adverse reactions during medicine was counted in the two group.Results:After 8 weeks of treatment, the total effective rate was 97.50%(39/40) in low-dose group and was 92.50%(37/40) in high-dose group, and there was no significant difference in the total effective rate between the two groups ( P>0.05). After 8 weeks of treatment, the 24 h SBPV, daytime SBPV, nighttime SBPV, 24 h DBPV, daytime DBPV and circadian rhythm in the two groups were significantly decreased compared with those before treatment, and the 24 h SBPV, daytime SBPV, daytime DBPV and circadian rhythm in high-dose group were significantly lower than those in low-dose group: (9.53 ± 1.73)% vs. (10.89 ± 1.98)%, (9.14 ± 1.90)% vs. (10.33 ± 2.07)%, (11.56 ± 2.78)% vs. (13.06 ± 3.16)%, (4.78 ± 1.56)% vs. (5.70 ± 1.81)%( P<0.05). After 8 weeks of treatment, the levels of NO, folate and HDL-C in the two groups were significantly increased compared with those before treatment, and the levels with in high-dose group were significantly higher than those in low-dose group: (67.16 ± 13.14) μmol/L vs.(60.53 ± 12.50) μmol/L, (14.94 ± 2.07) mmol/L vs.(13.83 ± 2.28) mmol/L, (1.42 ± 0.15) mmol/L vs. (1.31 ± 0.18)mmol/L ( P<0.05). The levels of ET, YKL-40, sICAM-1, TC, TG and LDL-C in the two groups were significantly decreased compared with those before treatment, and the levels in high-dose group were significantly lower than those in low-dose group: (33.63 ± 5.15) ng/L vs. (37.44 ± 5.13) ng/L, (32.68 ± 6.16) μg/L vs. (36.94 ± 6.03) μg/L, (203.78 ± 41.19) ng/L vs. (249.93 ± 50.81) ng/L, (6.78 ± 1.03) mmol/L vs. (7.38 ± 1.30) mmol/L, (2.88 ± 0.61) mmol/L vs. (3.39 ± 0.85) mmol/L, (3.14 ± 1.05) mmol/L vs. (3.85 ± 1.44) mmol/L ( P<0.05). Conclusions:Different doses of atorvastatin combined with valsartan are effective in the treatment of hypertension, but high dose of atorvastatin combined with valsartan has better effects on blood pressure variability and circadian rhythm, and can effectively improve vascular endothelial function.
