本態性高血圧症の血圧概日変動に対するＤｉｌｔｉａｚｅｍの時間治療について

Abstract

The aim of this study was to assess the differences in the characteristic effects of diltiazem and diltiazem-retard with 3 medication schedules on circadian profile of blood pressure and heart rate. The study was performed in 26 essential hypertensive patients.Blood pressure and heart rate were measured every 30 minutes before and after medication administration using an ambulatory blood pressure monitoring device (model ABPM-630, Nippon Colin, Aichi) for 48 hours. The data were analyzed with nonparametric estimation and cosinor method. The patients were divided into four groups; three groups with a dipper pattern and one group with a non-dipper pattern. Each group had different medication timing. Systolic and diastolic blood pressures were decreased significantly in the four groups. The time when the effect occured varied in the four groups. Diltiazem-retard (100 or 200 mg, sid, at 08: 00, 4 wks, n=7) had antihypertensive effects especially during the night rest span. Diltiazem-retard (100 or 200 mg, sid, at 19: 00, 4 wks, n= 6) had antihypertensive effects especially during the day active span and inhibited the morning rise of blood pressure. Diltiazem (30 or 60 mg, tid, 4 wks, n=5) had antihypertensive effects especially during the day active span in dipper hypertension.However, in non-dipper hypertensive patients, diltiazem (30 or 60 mg, tid, 4 wks, n=8) had antihypertensive effects especially during the night rest span. Evening administration with diltiazem-retard appears to be more efficacious than the other therapies.