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【正文】 ? ABPM有助于夜間高血壓病人篩查并指導(dǎo)治療， 避免夜間血壓過度降低。 The First Clinical College of Harbin Medical University ? 調(diào)整服藥時(shí)間 Minutolo 等發(fā)現(xiàn) （ 32例 CKD伴夜間血壓增高） 將不同降壓藥物服用時(shí)間從早改到晚 , 結(jié)果顯示： Am J Kidney Dis. 2020 Dec。 Circulation 100(15), 1635–1638 (1999) Chronobiol. Int. 25(6), 950–970 (2020) Hypertension 47(3), 352–358 (2020). The First Clinical College of Harbin Medical University The ABPM substudy of the AngloScandinavian cardiac outes trial (n=1905) showed a more significant reduction of nocturnal BP with an amlodipine–perindopril regimen than with atenolol–thiazide, despite the fact that the daytime BP was higher in the former group, which might account for the lower cardiovascular events in the amlodipine–perindopril group. J Hypertens 2020。 Blood Press. 2020。96(6):185962 The First Clinical College of Harbin Medical University ? 年輕非高血壓黑人高鉀攝入（ 80mg/d) 使 所有非杓型 血壓狀態(tài) 恢復(fù)為杓型 血壓狀態(tài)，但白天血壓無明顯變化。 ? 日間血壓值相對降低、夜間血壓相對升高， 傾向非杓型 。2:99–103 The First Clinical College of Harbin Medical University ? NDIP hypertensive patients have an impaired nocturnal melatonin secretion. Blood Pressure. 2020。12:35–39 Hypertension. 1997。 p = ) . DM The First Clinical College of Harbin Medical University 阻塞性睡眠呼吸暫停低通氣綜合征 (Obstructive sleep apneahyponea syndrome, OSAHS) ? 40歲以上人群中，美國患病率為 2%4%，澳大利亞高達(dá) %，我國香港地區(qū) %，上海市 %，長春市% ，男性多于女性，老年人、肥胖患病率更高 。52。 透析患者伴夜間收縮壓增高者心血管死亡率增加 41%。 The First Clinical College of Harbin Medical University ? 許多研究證實(shí)，亞洲人和黑人夜間血壓增高比 高加索人 （白人） 更常見。 《 中國高血壓防治指南 》 2020 ? 有學(xué)者建議用夜間 睡眠血壓 替代夜間血壓。 The First Clinical College of Harbin Medical University 2020。15:525–530 The First Clinical College of Harbin Medical University ? 2020年 ,上海瑞金醫(yī)院 觀察浙江景寧畬族自治縣 14個(gè)村莊 2059位受試者 The First Clinical College of Harbin Medical University ? 單純夜間高血壓（ 22:00 4:00平均血壓 ≥ 120/70mmHg,白天血壓正常 )達(dá) %； 日夜高血壓 %； 單純白天高血壓 (從 8: 00 到 16: 00 平均血壓 135/ 85 mm Hg, 夜間血壓正常 )為 %。 the incidence of hemorrhagic stroke was more prominent in the reverse dipping group (29%) than in other dipping groups (%, P=). Hypertension. 2020 Oct。 ? 腎小球?yàn)V過率 （ GFR） 與夜間 /白天血壓比值 呈反比 。 Hypertension. 1996。27:481490 ＊ ＊正常：血壓正常的個(gè)體 The First Clinical College of Harbin Medical University 褪黑素水平降低 ? Melatonin has been shown to suppress sympathetic activity and to reduced serum norepinephrine levels. ? The normal surge of melatonin during sleep may contribute to the nocturnal suppression of the sympathetic nervous system and contribute to arterial vasodilatation that leads in turn to nocturnal BP fall. Am J Cardiol. 1999。50:333339 The First Clinical College of Harbin Medical University ? AHA夜間血壓診斷標(biāo)準(zhǔn)： Hypertension. 2020 Jul。 ? Uzu 等證實(shí)：鹽敏感性高血壓患者限鹽程度 與夜間血壓下降幅度 呈正相關(guān) 。 ? 補(bǔ)鉀最可通過多食用含鉀豐富的 水果 、 蔬菜 等或 添加鉀鹽 (低鈉鹽）。 p = ) , also acpanied by greater sleepBP lowering (% vs 6% fall。 ? Have a favorable effect on nocturnal hypertension. J. Hypertens. 24(10), 2047–2055 (2020). Minerva Endocrinol. 29(1), 11–17 (2020). The First Clinical College of Harbin Medical University ?不宜選擇具
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