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目的:研究不同剂量阿托伐他汀联合缬沙坦对高血压患者血压变异性（BPV）及昼夜节律的影响。方法:将2018年3月至2019年3月合肥市第一人民医院收治的80例2、3级高血压患者按照随机数表法均分为低剂量组（20 mg/d阿托伐他汀联合缬沙坦治疗）和高剂量组（40 mg/d阿托伐他汀联合缬沙坦治疗）。比较两组治疗8周后疗效，记录治疗前、治疗8周后BPV、昼夜节律、血管内皮因子[一氧化氮（NO）、内皮素（ET）]、血清疾病相关因子[人软骨糖蛋白（YKL-40）、可溶性细胞间黏附分子1（sICAM-1）、叶酸]、血脂[总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）]水平，统计两组用药期间不良反应发生情况。结果:治疗8周后，低剂量组总有效率为97.50%（39/40），高剂量组总有效率为92.50%（37/40），两组总有效率比较差异无统计学意义（n P>0.05）。治疗8周后，两组患者24 h动态血压平均收缩压的标准差（SBPV）、白昼SBPV、夜间SBPV、24 h动态血压平均舒张压的标准差（DBPV）、白昼DBPV、昼夜节律均较治疗前显著下降，高剂量组24 h SBPV、白昼SBPV、白昼DBPV、昼夜节律均明显低于低剂量组[（9.53 ± 1.73）%比（10.89 ± 1.98）%、（9.14 ± 1.90）%比（10.33 ± 2.07）%、（11.56 ± 2.78）%比（13.06 ± 3.16）%、（4.78 ± 1.56）%比（5.70 ± 1.81）%]，差异均有统计学意义（n P<0.05）。治疗8周后，两组患者NO、叶酸、HDL-C水平均较治疗前显著上升，高剂量组明显高于低剂量组[（67.16 ± 13.14）μmol/L比（60.53 ± 12.50）μmol/L、（14.94 ± 2.07）mmol/L比（13.83 ± 2.28）mmol/L、（1.42 ± 0.15）mmol/L比（1.31 ± 0.18）mmol/L]（n P均<0.05）；两组患者ET、YKL-40、sICAM-1、TC、TG、LDL-C水平均较治疗前显著下降，高剂量组明显低于低剂量组[（33.63 ± 5.15）ng/L比（37.44 ± 5.13）ng/L、（32.68 ± 6.16）μg/L比（36.94 ± 6.03）μg/L、（203.78 ± 41.19）ng/L比（249.93 ± 50.81）ng/L、（6.78 ± 1.03）mmol/L比（7.38 ± 1.30）mmol/L、（2.88 ± 0.61）mmol/L比（3.39 ± 0.85）mmol/L、（3.14 ± 1.05）mmol/L比（3.85 ± 1.44）mmol/L]，差异均有统计学意义（n P0.05). After 8 weeks of treatment, the 24 h SBPV, daytime SBPV, nighttime SBPV, 24 h DBPV, daytime DBPV and circadian rhythm in the two groups were significantly decreased compared with those before treatment, and the 24 h SBPV, daytime SBPV, daytime DBPV and circadian rhythm in high-dose group were significantly lower than those in low-dose group: (9.53 ± 1.73)% vs. (10.89 ± 1.98)%, (9.14 ± 1.90)% vs. (10.33 ± 2.07)%, (11.56 ± 2.78)% vs. (13.06 ± 3.16)%, (4.78 ± 1.56)% vs. (5.70 ± 1.81)%(n P<0.05). After 8 weeks of treatment, the levels of NO, folate and HDL-C in the two groups were significantly increased compared with those before treatment, and the levels with in high-dose group were significantly higher than those in low-dose group: (67.16 ± 13.14) μmol/L vs.(60.53 ± 12.50) μmol/L, (14.94 ± 2.07) mmol/L vs.(13.83 ± 2.28) mmol/L, (1.42 ± 0.15) mmol/L vs. (1.31 ± 0.18)mmol/L (n P<0.05). The levels of ET, YKL-40, sICAM-1, TC, TG and LDL-C in the two groups were significantly decreased compared with those before treatment, and the levels in high-dose group were significantly lower than those in low-dose group: (33.63 ± 5.15) ng/L vs. (37.44 ± 5.13) ng/L, (32.68 ± 6.16) μg/L vs. (36.94 ± 6.03) μg/L, (203.78 ± 41.19) ng/L vs. (249.93 ± 50.81) ng/L, (6.78 ± 1.03) mmol/L vs. (7.38 ± 1.30) mmol/L, (2.88 ± 0.61) mmol/L vs. (3.39 ± 0.85) mmol/L, (3.14 ± 1.05) mmol/L vs. (3.85 ± 1.44) mmol/L (n P<0.05).n Conclusions:Different doses of atorvastatin combined with valsartan are effective in the treatment of hypertension, but high dose of atorvastatin combined with valsartan has better effects on blood pressure variability and circadian rhythm, and can effectively improve vascular endothelial function.