Objective To observe the clinical treatment characteristics and related influencing factors of patients with nocturnal hypertension(NH).Methods A cross-sectional study was conducted to collect 829 patients diagnosed with NH through ambulatory blood pressure monitoring at the First Affiliated Hospital of Hunan University of Medicine from January 2021 to December 2022.General demographic data,biochemical test indicators,24-hour ambulatory blood pressure monitoring data and clinical data on underlying diseases were also collected.According to the different types of medication treatment for patients,NH patients were divided into a single-drug group(n=294),a dual-drug combination group(n=400),and a multi-drug combination group(n=135).Angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor antagonist(ARB)or calcium antagonist was used in the single-drug group.ACEI/ARB combined with calcium antagonistdual were used in the double-drug group,and any three or four combinations of ACEI/ARB,calcium antagonists,[3-blockers and diuretics were used in multi-drug combination group.Compare the clinical data of three groups of patients and analyze their influencing factors.Results After treatment with different combinations of antihypertensive drugs,the nighttime systolic blood pressure(NSBP)and nighttime diastolic blood pressure(NDBP)of NH patients in the single-drug group,dual-drug combination group,and multi-drug combination group were significantly different from before treatment(all P＜0.001);The decrease of NSBP and NDBP in the dual-drug combination group(21.75％,20.06％)was significantly higher than that in the single-drug group(17.60％,15.26％)and the multi-drug combination group(18.23％,16.51％),(P＜0.05);Multivariate logistic regression analysis showed that smoking(OR=2.142,P=0.016),obesity(OR=1.563,P=0.029),poor sleep(OR=1.412,P=0.040),stroke(OR=1.806,P=0.021)and concomitant coronary heart disease(OR=3.017,P=0.000)were independent risk factors of nocturnal blood pressure.Conclusion All three groups of patients can effectively reduce nighttime blood pressure,but the combination of ACEI/ARB and calcium antagonists have a better effect on reducing nighttime blood pressure.Quitting smoking,losing weight,controlling cardiovascular and cerebrovascular diseases and improving sleep quality are important means of reducing nighttime blood pressure.
维普
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