Treatment of Hypertension with Nifedipine, A Calcium Antagonistic Agent
Treatment of Hypertension with Nifedipine, A Calcium Antagonistic Agent
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钙拮抗剂硝苯地平治疗高血压
作者：
M. Olivari;C. Bartorelli;A. Polese;C. Fiorentini;P. Moruzzi;M. Guazzi
27例原发性高血压患者单次服用硝苯地平（10 mg）后的血流动力学监测（舒张压≥ 110 mm Hg）证明这种钙拮抗剂具有强效的小动脉血管舒张作用，这会导致（30分钟时为对照组的-21%）持续（120分钟时为对照组的-16%）平均动脉压下降，心输出量脉率升高。相同的患者接受口服治疗3周。小时血压读数显示：1）每次给药的降压反应持续8-12小时; 2）硝苯地平每6小时一次，在24小时内显著降低血压，无体位性低血压。副作用持续时间较短（5例患者头痛，8例患者心悸，无心律失常，5例患者面部和腿部有烧灼感，5例患者偶发性期外收缩），随着持续治疗趋于消失。研究期间未观察到耐药性、钠潴留、血浆容量扩张、肾素释放或心绞痛的发生。虽然这些发现似乎区分硝苯地平从其他血管扩张剂目前用于治疗高血压，更广泛的经验，更长的试验硝苯地平作为抗高血压药物之前，可以得出结论，在这些特定的方面。
Hemodynamic monitoring after a single dose (10 mg) of nifedipine in 27 primary hypertensive subjects (diastolic pressure ≥ 110 mm Hg) documented that this calcium antagonistic agent exerts a potent arteriolar vasodilating action, which results in prompt (−21% of control at 30 minutes) persistent (−16% of control at 120 minutes) fall in mean arterial pressure associated with a rise in cardiac output pulse rate. The same patients received oral treatment for 3 weeks. Hourly pressure readings showed that 1) the antihypertensive response to each dose lasts 8–12 hours; 2) nifedipine every 6 hours significantly reduced blood pressure throughout the 24 hours, without postural hypotension. Side effects were short-lasting (headache in five patients, palpitation without arrhythmias in eight patients, burning sensation in the face legs in five patients sporadic extrasystoles in five patients) tended disappear with continued treatment. Development of drug resistance, sodium retention, plasma volume expansion, renin release or angina pectoris were not observed during the study. Although these findings seem to differentiate nifedipine from other vasodilators currently used in the treatment of hypertension, broader experience more prolonged trials with nifedipine as an antihypertensive agent will be needed before conclusions can be drawn on these particular aspects.