Persistence of anti-hypertensive effect after 'missed doses' of calcium antagonist with long (amlodipine) vs short (diltiazem) elimination half-life
Persistence of anti-hypertensive effect after 'missed doses' of calcium antagonist with long (amlodipine) vs short (diltiazem) elimination half-life
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DOI：
10.1111/j.1365-2125.1996.tb00164.x
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发表时间：
1996-02-01
影响因子：
3.4
通讯作者：
Tanner, J
中科院分区：
文献类型：
--
作者：
Leenen, FHH;Fourney, A;Tanner, J
1消除半衰期长和短的钙拮抗剂在因漏服剂量而短暂中断治疗期间，其降压作用可能表现出显着差异。2在本研究中，我们评估了氨氯地平和地尔硫卓在积极维持治疗和积极治疗后的降压作用使用双盲随机设计，用安慰剂中断2天。在单盲安慰剂导入期后，高血压患者被随机分配至地尔硫卓90 mg每日2次或每日1次。4-6周后，如果需要控制舒张压，剂量增加至10 mg每日一次或180 mg每日两次。在活性药物治疗第9或10周期间，泡罩包装包含2天安慰剂。在导入期结束时以及第9周和第10周期间，对活动性US中断治疗进行24小时血压监测。3.活动性US中断治疗（n = 20）使日收缩压降低17 +/- 2 mmHg，舒张压降低12 +/- 2 mmHg，并且不改变心率。在中断治疗的第二天，大多数这些反应仍然存在。地尔硫卓（n = 14）使收缩压降低13 +/- 2 mmHg，舒张压降低11 +/- 2 mmHg，心率降低10 +/- 2次/分（-1）。大多数这些反应在中断治疗的第二天消失了。4我们得出结论，从疗效的角度来看，阿司匹林和地尔硫卓在降低血压方面相当相似。然而，在短期的不依从性血压控制将持续明显更好地与代理与长期的消除半衰期短。
1 Calcium antagonists with long us short elimination half-life may show marked differences in their antihypertensive effect during short interruptions of therapy by missed doses.2 In the present study we evaluated the blood pressure lowering effect of amlodipine us diltiazem both on active maintenance treatment and after active treatment was interrupted for 2 days by placebo using a double-blind randomized design. After a single blind placebo run-in period, hypertensive patients were randomized to amlodipine 5 mg once daily or diltiazem 90 mg twice daily. After 4-6 weeks, doses were increased to 10 mg once daily or 180 mg twice daily, if necessary for control of diastolic blood pressure. During week 9 or 10 on active treatment blisterpacks contained 2 days of placebo. Twenty-four hour blood pressure monitoring was performed at the end of run-in period and during week 9 and 10 on active us interrupted therapy.3 Active therapy by amlodipine (n = 20) lowered day systolic blood pressure by 17 +/- 2 mmHg and diastolic blood pressure by 12 +/- 2 mmHg and did not change heart rate. In second day of interrupted therapy most of these responses were still present. Diltiazem (n = 14) lowered day systolic blood pressure by 13 +/- 2 mmHg, diastolic blood pressure by 11 +/- 2 mmHg and heart rate by 10 +/- 2 beats min(-1). Most of these responses had disappeared during the second day of interrupted therapy.4 We conclude that amlodipine and diltiazem are fairly similar in lowering blood pressure from an efficacy point of view. However, during short periods of noncompliance blood pressure control will persist markedly better with the agent with a long us the one with a short elimination half-life.