hypertension
Conditions
Interventions
1:Morning medication (6 -10:00 am) + bedtime placebo (20:00-22:00 pm)
2:Morning placebo (6:00-10:00 am) + bedtime medication (20:00-22:00 pm)
Sponsors
The First Affiliated Hospital of USTC (Anhui Provincial Hospital)
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: Case selection criteria:? age 18 years old, gender unlimited, regular schedule and rest time; ?not receiving antihypertensive treatment or stopping antihypertensive drugs for more than 2 weeks; ? signing informed consent form and being able to participate in follow-up on time. ?Compliance with the diagnostic criteria of hypertension: referring to the China guidelines for Prevention and treatment of Hypertension (2018 Edition), the diagnostic criteria of hypertension are as follows: without antihypertensive drugs, the clinic blood pressure, systolic blood pressure = 140mmHg and / or diastolic blood pressure = 90mmHg were measured three times in different days. The patient has a history of hypertension and is currently using antihypertensive drugs. Although the blood pressure is lower than 140/90mmHg, it should still be diagnosed as hypertension. At the same time, 24-hour ambulatory blood pressure monitoring was performed, and the nocturnal blood pressure of the selected patients was = 120/70mmHg. ? in accordance with the OSAHS diagnostic criteria of the sleep apnea group of the Respiratory Society of the Chinese Medical Association in 2012, there were typical nocturnal snoring with apnea, daytime sleepiness [Epworth sleepiness scale (EpworthsleepinessscaleESS) score = 9] and other symptoms. Physical examination showed stenosis and obstruction in any part of the upper airway, apnea hypopnea index (AHI) = 5 / h. Or daytime sleepiness was not obvious (ESS score < 9), AHI = 10 times / h or one or more OSA complications (cognitive impairment, hypertension, coronary heart disease, etc.).
Exclusion criteria
Exclusion criteria: ?Planned pregnancy or pregnancy or lactation women; ?Bilateral renal artery stenosis; ? Hyperkalemia (serum potassium > 5.5mmol/L), chronic renal insufficiency (creatinine>265umol/L); ?Malignant hypertension, hypertensive emergency or subemergency, hypertensive crisis and hypertensive encephalopathy; ?history of angioedema, drug-related or other causes; or history of allergy to angiotensin receptor antagonists, angiotensin converting enzyme inhibitors or renin inhibitors; ? history of alcoholism or drug addiction; ?working night shifts or shifts; ?cardiovascular disease and some related diseases, such as unstable angina pectoris, heart failure, life-threatening arrhythmias, atrial fibrillation, renal failure and III-IV grade retinopathy; ? deep dipper blood pressure; ?people who cannot tolerate ambulatory blood pressure measurements and other situations that cannot participate in clinical studies.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Reduction of nocturnal mean systolic blood pressure; | — |
Secondary
| Measure | Time frame |
|---|---|
| 24-hour ambulatory blood pressure;Clinic blood pressure; | — |
Countries
China
Contacts
Public ContactXiaofan Yu
The First Affiliated Hospital of USTC (Anhui Provincial Hospital)
Outcome results
None listed