Combination of short-effect and long-effect antihypertensive drugs in treatment of patients with morning surge and spoon type hypertension

Objective To evaluate the efficacy of combination therapy with short-effect and long-effect antihypertensive drugs in treatment of patients with morning surge and spoon type hypertension.Methods Ninety patients with spoon type or super-spoon type hypertension,or morning surge were enrolled in the study.Blood pressure was recorded by 24h ambulatory blood pressure monitoring(ABPM)and the hypertension was diagnosed according to the criteria formulated by the WHO/ISH in 1999.All patients were randomized to group A(Lotensin 10mg administered at 6 a.m.and 6 p.m.)or group B(Betaloc 25 mg administered in the morning waking up and Lotensin administered at 11 a.m.)or group C(Captopril 25 mg administered in the morning waking up and Lotensin administered at 11 a.m.).Two weeks before and after treatment parameters were determined,including 24h MBP,morning MBP,the lowest value of blood pressure during a night,change value of blood pressure in sleeping in the morning,smoothness index(SBP and DBP was included in this parameter).Results 24h MBP,morning MBP and change value of blood pressure in sleeping in the morning were significantly reduced(B C versus A,P0.01).24h MBP and morning MBP were decreased markedly(B versus C,P0.05).The systolic pressure SI was higher in group C than that in group A(P0.01),and no significant difference was detected among group B and group A.There was no significant difference of diastolic pressure SI in three groups.Conclusion The combination with short-effect and long-effect antihypertensive drugs is effective in treatment of patients with spoon type hypertension or morning surge,by which the BP can be decteased stably and the 24h MBP,morning MBP and change value of blood pressure in sleeping in the morning were also controlled satisfactorily.