The Effects Of Medication At Different Times On Non-dipping Hypertension And Left Ventricular Structure

Objection：To investigate the effects of different time taking nifedipine GITS on primary non dipper hypertension and left ventricular structure.Method：144patients were selected from patients in our hospital and outpatient clinical diagnosis of primary non dipper hypertension(1and2)during the period of2012.8-2013.8.All patients with non-dipper pattern of night BP were treated with nifedipine GITS(30mg/d) with morning dose(n=72) and evening dose program (n=72)for24weeks.The two groups were compared ambulatory blood pressure parameters,LVMI,compliance rate and correction rate,further analysis of the relationship between the descending degree of LVMI and the rising degreeof nBP drop rate.Result：1.ABPM showed that：both programs effectively decreased BP throughout the day,while evening program reduced night BP more pronouncedly.Thecompliance rate of nBP with evening program was greatly higher than morning program.BP circadian rhythm transformed from non-dipper to dipper was found in17.1%in morning program and45.7%in the evening program,there wasa great difference between them.The rising degree of nBP drop rate had a significant difference between evening program and morning program.2.Echocardiography showed that：In morning program,LVMI were not obvious difference between pretherapy and post-treatment.While in evening program,there were differences between pretherapy and post-treatment in the LVMI.Evening program wasmore effective in descending LVMI.Correlation analysis showed that there wasa correlation is about the descending degree of LVMI and the rising degree ofnBP drop rate.Conclusion：For patients with non-dipper hypertension(1and2),both morning and evening programs of nifedipine administration were effective in decreasingBP throughout the day. Compared with morning program,evening program migh t be more effective in decreasing the high night BP load and alteration from non-dipper to dipper pattern.In addition,evening program improved left ventricular remodeling more pronouncedly.The descending degree of LVMI and the risingdegree of nBP drop rate had a correlation after treatment.