Prichard Brian N C, Jäger Bodo A, Luszick Joachim H, Küster Leslie J, Verboom Caes N, Hughes Peter R, Sauermann Wilhelm, Küppers Hartmut E
Division of Clinical Pharmacology & Toxicology, University College London Medical School, The Rayne Institute, UK.
Blood Press. 2002;11(3):166-72. doi: 10.1080/080370502760050403.
To compare the antihypertensive efficacy and tolerability of the imidazoline I1-receptor agonist moxonidine, administered as a single daily dose of 0.6 mg, with the angiotensin-converting enzyme inhibitor enalapril (20 mg o.d.) in patients with mild to moderate essential hypertension.
A total of 154 patients were enrolled and randomized to placebo (n = 50), moxonidine (0.2 mg o.d.; n = 51) or enalapril (5 mg o.d.; n = 53) for 2 weeks. Dosages were then increased to moxonidine 0.6 mg o.d. or enalapril 20 mg o.d. for a further 6 weeks. Blood pressure responses to therapy were measured using conventional office techniques and by 24-h ambulatory blood pressure monitoring.
The average reduction in sitting blood pressure with moxonidine was similar to that achieved with enalapril (24.9 +/- 20.7/13.2 +/- 8.4 mmHg vs 21.9 +/- 17.1/11.9 +/- 7.5 mmHg, respectively) and significantly superior to that seen with placebo (1.2 +/- 14.4/2.3 +/- 7.0 mmHg; p < 0.001). Reductions in blood pressure after 8 weeks of treatment were as follows: moxonidine, from 166.2 +/- 15.5/101.3 +/- 4.0 to 141.2 +/- 15.7/88.1 +/- 7.7mmHg; enalapril, from 165.4 +/- 14.3/101.1 +/- 4.4 to 143.5 +/- 12.7/89.2 +/- 7.4 mmHg; and placebo, from 162.5 +/- 14.4/99.9 +/- 3.9 to 161.3 +/- 17.9/97.6 +/- 6.6 mmHg. Both moxonidine and enalapril produced sustained reductions in blood pressure during 24-h recording (p < 0.01 for overall effect of either drug vs placebo). Average 24-h blood pressure was reduced from 149.8 +/- 14.3/92.2 +/- 7.0 to 134.0 +/- 13.1/82.3 +/- 8.9 mmHg with moxonidine and from 146.5 +/- 13.0/ 92.5 +/- 7.2 to 131.1 +/- 11.0/82.1 +/- 8.8 mmHg with enalapril; the change with placebo was small (from 147.3 +/- 13.3/90.0 +/- 6.2 to 144.8 +/- 12.9/89.5 +/- 8.0 mmHg). Both drugs were generally well tolerated. No patients withdrew from the study because of drug-attributed adverse events.
Moxonidine 0.6 mg o.d. and enalapril 20 mg o.d. have similar antihypertensive efficacy.
比较每日单次服用0.6毫克的咪唑啉I1受体激动剂莫索尼定与血管紧张素转换酶抑制剂依那普利（每日20毫克）对轻至中度原发性高血压患者的降压疗效和耐受性。
共纳入154例患者，随机分为安慰剂组（n = 50）、莫索尼定组（每日0.2毫克；n = 51）或依那普利组（每日5毫克；n = 53），治疗2周。然后剂量分别增加至莫索尼定每日0.6毫克或依那普利每日20毫克，再治疗6周。采用传统诊室技术和24小时动态血压监测来测量治疗后的血压反应。
莫索尼定使坐位血压的平均降幅与依那普利相似（分别为24.9±20.7/13.2±8.4毫米汞柱和21.9±17.1/11.9±7.5毫米汞柱），且显著优于安慰剂组（1.2±14.4/2.3±7.0毫米汞柱；p<0.001）。治疗8周后的血压降幅如下：莫索尼定，从166.2±15.5/101.3±4.0降至141.2±15.7/88.1±7.7毫米汞柱；依那普利，从165.4±14.3/101.1±4.4降至143.5±12.7/89.2±7.4毫米汞柱；安慰剂，从162.5±14.4/99.9±3.9降至161.3±17.9/97.6±6.6毫米汞柱。在24小时记录期间，莫索尼定和依那普利均使血压持续下降（两种药物与安慰剂相比的总体效应p<0.01）。莫索尼定使24小时平均血压从149.8±14.3/92.2±7.0降至134.0±13.1/82.3±8.9毫米汞柱，依那普利使血压从146.5±13.0/92.5±7.2降至131.1±11.0/82.1±8.8毫米汞柱；安慰剂组的变化较小（从147.3±13.3/90.0±6.2降至144.8±12.9/89.5±8.0毫米汞柱）。两种药物总体耐受性良好。没有患者因药物相关不良事件退出研究。
每日0.6毫克的莫索尼定和每日20毫克的依那普利具有相似的降压疗效。
