Ruilope L M, Casal M C, Guerrero L, Alcázar J M, Férnandez M L, Lahera V, Rodicio J L
Hypertensive Unit, 12 de Octubre Hospital, Madrid, Spain.
Drugs. 1992;44 Suppl 1:94-8. doi: 10.2165/00003495-199200441-00017.
Information is limited regarding the efficacy of antihypertensive drugs in patients with hypertension associated with renal insufficiency. To address this question, a group of 14 outpatients with essential hypertension and mild renal insufficiency received slow release verapamil 240 mg/day for 14 days after a 4-week washout period. Patients were randomly assigned to a low (4 g/day) or high (11 g/day) salt diet, and crossed over to the alternative diet after 7 days. 24-Hour blood pressure monitoring was performed at the end of the washout period and after 7 and 14 days during verapamil treatment. Verapamil induced a significant fall in mean 24-hour blood pressure that was similar for patients on both diets (p < 0.01). As expected, natriuresis increased significantly during high sodium intake (p < 0.01), and bodyweight fell significantly when sodium intake was reduced (p < 0.05). Meanwhile, serum creatinine and creatinine clearance remained stable. These results indicate that the antihypertensive effect of verapamil is independent of sodium intake even in the presence of mild renal insufficiency.
关于抗高血压药物对伴有肾功能不全的高血压患者的疗效，相关信息有限。为解决这一问题，一组14例原发性高血压合并轻度肾功能不全的门诊患者，在经过4周的洗脱期后，接受240毫克/天的缓释维拉帕米治疗，为期14天。患者被随机分配到低（4克/天）盐饮食或高（11克/天）盐饮食组，并在7天后交叉到另一种饮食组。在洗脱期结束时以及维拉帕米治疗的第7天和第14天后，进行24小时血压监测。维拉帕米使平均24小时血压显著下降，两种饮食组的患者情况相似（p<0.01）。正如预期的那样，高钠摄入期间尿钠排泄显著增加（p<0.01），而钠摄入减少时体重显著下降（p<0.05）。同时，血清肌酐和肌酐清除率保持稳定。这些结果表明，即使存在轻度肾功能不全，维拉帕米的降压作用也与钠摄入无关。
