摘要
非杓型高血压对靶器官损害明显,是心脑血管疾病的一个重要危险因素。血压24 h昼夜节律损伤,夜间血压与白天血压(非杓型和反杓型)相比下降不足,甚至升高。非杓型高血压的病理生理学目前仍不清楚,许多因素,如糖尿病、代谢症候群、肥胖、睡眠呼吸暂停综合征、肾脏疾病均与夜间血压异常升高和非生理性昼夜节律有关,因此非杓型高血压的机制不明确。非杓型高血压的治疗也是一个重要问题,时间疗法提供了迄今为止最好的结果。某些类型的降压药对夜间血压的调节更为有效,但给药时机似乎在降低夜间血压和昼夜节律从非生理性向生理性转变方面起着更为重要的作用。降低夜间高血压,将非杓型调整为杓型昼夜节律对于非杓型高血压患者的受益还需要进一步研究。
Non-dipper hypertension has obvious damage to target organs,and is an important risk factor for cerebrovascular disease.The 24-hour circadian rhythm of blood pressure is injuried,nighttime blood pressure(non-dipper and anti-dipper type)decreases insufficiently compared to the daytime,or even increases.The pathophysiology of non-dipper hypertension is still unclear,because many factors,such as diabetes,metabolic syndrome,obesity,sleep apnea syndrome,kidney disease,are associated with abnormal increase in nocturnal blood pressure and nonphysiological circadian rhythm.The treatment of non-dipper hypertension is also an important problem,and chronotherapy has provided the best results so far.Some types of antihypertensive drugs are more effective in regulating nocturnal blood pressure,but the medication timing seems to play a more important role in reducing nocturnal blood pressure and changing circadian rhythm from nonphysiological to physiological.The benefits of reducing nocturnal hypertension and adjusting the non-dipper to dipper circadian rhythm in the patients still need further studies.
作者
李杰
赵英强
LI Jie;ZHAO Yingqiang(Department of Cardiology,the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300150,China)
出处
《医学综述》
CAS
2021年第24期4857-4864,共8页
Medical Recapitulate
基金
国家重点研发计划课题(2019YFC1710005)。
关键词
非杓型高血压
发病机制
睡眠障碍
时间疗法
Non-dipper hypertension
Pathogenesis
Sleep disturbance
Chronotherapy
