Demonstration of safety in Alzheimer's patients for intervention with an anti-hypertensive drug Nilvadipine: results from a 6-week open label study
Demonstration of safety in Alzheimer's patients for intervention with an anti-hypertensive drug Nilvadipine: results from a 6-week open label study
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DOI：
10.1002/gps.2638
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发表时间：
2011-10-01
影响因子：
4
通讯作者：
Kenny, R. A.
中科院分区：
文献类型：
--
作者：
Kennelly, S. P.;Abdullah, L.;Kenny, R. A.
背景：尼伐地平可降低高血压患者从轻度认知障碍到阿尔茨海默病(AD)的转换率。然而，尼伐地平在AD患者中的安全性仍有待确定，因为在这一人群中，立位性低血压(OH)的发生率更高，他们可能更容易出现与血压下降进一步夸大相关的症状。目的：本研究的目的是调查尼伐地平在AD患者中的安全性和耐受性。方法：干预组(n=56)AD患者在6周内每天服用尼伐地平8 mg，与未接受干预的对照组(n=30)相比。使用自动血压计读数和动态血压监测仪(ABP)评估干预前后的收缩压(SBP)和舒张压(DBP)的差异，并使用测量仪评估OH的变化。结果：与未治疗的患者相比，接受治疗的患者的SBP显著降低，但DBP没有明显变化。初始血压(BP)较高的个体血压下降幅度较大，而血压正常的个体血压变化不大。虽然84%的患者存在OH，但在积极的STAND研究中记录的BP没有进一步下降。两组不良事件报告率差异无统计学意义。结论：尼伐地平对AD患者耐受性良好。这项研究支持进一步研究其作为AD潜在治疗方法的有效性。版权所有(C)2010 John Wiley&Sons，Ltd.
Background: Nilvadipine may lower rates of conversion from mild-cognitive impairment to Alzheimer's disease (AD), in hypertensive patients. However, it remains to be determined whether treatment with nilvadipine is safe in AD patients, given the higher incidence of orthostatic hypotension (OH) in this population, who may be more likely to suffer from symptoms associated with the further exaggeration of a drop in BP.Objective: The aim of this study was to investigate the safety and tolerability of nilvadipine in AD patients.Methods: AD patients in the intervention group (n = 56) received nilvadipine 8 mg daily over 6-weeks, compared to the control group (n = 30) who received no intervention. Differences in systolic (SBP) and diastolic (DBP) blood pressure, before and after intervention, was assessed using automated sphygmo-manometer readings and ambulatory BP monitors (ABP), and change in OH using a finometer. Reporting of adverse events was monitored throughout the study.Results: There was a significant reduction in the SBP of treated patients compared to non-treated patients but no significant change in DBP. Individuals with higher initial blood pressure (BP) had greater reduction in BP but individuals with normal BP did not experience much change in their BP. While OH was present in 84% of the patients, there was no further drop in BP recorded on active stand studies. There were no significant differences in adverse event reporting between groups.Conclusion: Nilvadipine was well tolerated by patients with AD. This study supports further investigation of its efficacy as a potential treatment for AD. Copyright (C) 2010 John Wiley & Sons, Ltd.