Effect Of Valsartan Amlodipine (Bobote) On Circadian Rhythm Of Blood Pressure In Patients With Hypertension

Objective: To investigate the effects of valsartan and amlodipine(times BO T)is effective and safety in the treatment of patients with hypertension,and to analyze the effect of drugs on circadian change of blood pressure in patients with hypertension.Methods: This study used a randomized,double blind method to select the object of observation,from December 2015-2016 year in September in the Affiliated Hospital of Qiingdao University,Department of cardiology outpatient and inpatient treatment in patients with hypertension in 200 patients were included in the study area,randomized patients were divided into 2 groups,each group of 100 cases.The control group was treated with valsartan hydrochlorothiazide tablets(CO Diovan)treatment,observation group were treated with valsartan and amlodipine(Telfast)treatment.According to ms DBP patients(mean sitting diastolic blood pressure(ms SBP),mean sitting systolic blood pressure)decreased and the effective standard,namely after 2 months of treatment compared with baseline ms DBP<90mm Hg or ms DBP reduced >10mm Hg rating antihypertensive efficacy;according to the patient's clinical symptoms,signs and biochemical ind icators of drug safety evaluation.C ircadian rhythm of blood pressure in patients with blood pressure variability and mean blood pressure.Blood pressure variability indication: 24 h SBP(24 hour mean systolic blood pressure(24h DBP),24 hour average diastolic blood pressure(d SBP)),d DBP(daytime average systolic blood pressure,daytime average diastolic blood pressure(n SBP),nocturnal mean systolic blood pressure(n DBP),night diastolic blood pressure).The patients were followed up for 4 months to record the MACE event.Results:(1)baseline data: there was no significant difference in baseline data between the two groups(p>0.05).The baseline information,including gender,age,BMI(body mass index),drinking history,smoking history,family history of hypertension,coronary heart disease,the disease duration;biochemical indicators including TG(triglyceride),LDL-C(low density lipoprotein cholesterol(HDL-C),high density lipoprotein cholesterol),TC(total cholesterol),UA(uric acid),FPG(fasting blood glucose).(2)the antihypertensive efficacy: comparison of two groups of patients before treatment,ms DBP and ms SBP levels,the difference was not statistically significant(p>0.05);after 8 weeks of treatment,the observation group ms DBP and ms SBP group than in the control group,compared two groups of data,the difference was statistically significant(p<0.05);(3)There were no significant differences in 24 h SBP,24 h DBP,d SBP,d DBP,n SBP and n DBP between the two groups before treatment(p> 0.05).The 24 h SBP,24 h DBP,d SBP,d DBP,n SBP and n DBP of the two groups were decreased at the 4th and 8th week after treatment.There was significant difference between the treatment group and the control group at n SBP at 4 weeks after treatment(p <0.05);There was no statistically significant difference between the remaining after 4 weeks' treatment(p> 0.05).At the 8th week after treatment,the n SBP and n DBP in the treatment group were compared with those in the control group,and the difference was statistically significant(p <0.05).(4)Comparison of blood pressure variability: There was no significant difference in the levels of 24 h SBPV,24 h DBPV,d SBPV,d DBPV,n SBPV and n DBPV between the treatment group and the control group before treatment(p> 0.05).After treatment,the levels of 24 h SBPV,24 h DBPV,d SBPV,d DBPV,n SBPV and n DBPV were decreased in both groups.The levels of DBPV,d DBPV and n DBPV in the treatment group were significantly lower than those in the control group at the 4th week after treatment,th e difference was statistically significant(P <0.05).At the 8th week after treatment,24 h SBPV,24 h DBPV,d SBPV,d DBPV,n SBPV and n DBPV were significantly decreased in the two groups,and the observed group was significantly lower than the control group,the difference was statistically significant(P <0.05).(5)blood pressure variability: observation group and control group after treatment fourth,8 weeks of 24 h SBPV,24 h DBPV,d SBPV,d DBPV,n SBPV and n DBPV levels before treatment had significantly decreased(p<0.05);compared with the control group,the observation group decreased more greatly,compared with two groups of data,the difference was statistically significant(p<0.05);in the observation group after treatment for fourth weeks,24 h DBPV,d DBPV a nd n DBPV had decreased significantly compared with the control group,the difference was statistically significant(p<0.05).(6)the incidence of MACE events in the treatment group was lower than that in the control group,but there was no significant difference in the incidence of MACE events between the two groups(p>0.05).(7)the incidence of MACE events in the observation group was lower than that in the control group,the difference between the two groups was statistically significant(p<0.05).Conclusion:(1)compared with valsartan hydrochlorothiazide tablets in the treatment of hypertension,Valsartan and Amlodipine Tablets is more effective in the treatment of hypertension.(2)the adverse effects of valsartan hydrochlorothiazide tablets and Valsartan and Amlodipine Tablets in the treatment of hypertension were low,and the patients could tolerate it.(3)compared with valsartan hydrochlorothiazide tablets,the former was more prominent in lowering the blood pressure level of patients with hypertens ion in the first half of the year Valsartan and Amlodipine Tablets(4)and valsartan hydrochlorothiazide tablets can reduce the variability of blood pressure in patients with hypertension,but the former can further reduce blood pressure variability,especially in diastolic blood pressure variability is most prominent.(5)compared with valsartan hydrochlorothiazide tablets Valsartan and Amlodipine Tablets,the former is more prominent in the improvement of endothelial function,improve the mechanism of blood pressure variability can improve vascular endothelial function.(6)the adverse effects of valsartan hydrochlorothiazide tablets and Valsartan and Amlodipine Tablets in the treatment of hypertension were low,and the patients could tolerate it.