Espinel C H, Bruner D E, Davis J R, Williams J L
Georgetown University School of Medicine, Washington, D.C.
Clin Ther. 1992 Nov-Dec;14(6):835-44.
A prospective, investigator-blinded, randomized study was conducted to compare the efficacy and tolerability of enalapril and verapamil in the treatment of isolated systolic hypertension in elderly patients. Of the 115 patients who completed the study, 58 received enalapril and 57 verapamil. The goal of treatment was a systolic blood pressure < 160 mmHg and a reduction of at least 20 mmHg below baseline. The initial daily dose of enalapril was 5 mg, and of verapamil 240 mg. The dosage was titrated upward until the goal blood pressure was achieved. At the end of the titration period, systolic and diastolic blood pressures were significantly decreased (P < 0.001) in both patient groups. Blood pressure remained significantly decreased (P < 0.001) in both groups during the 8-week maintenance treatment period. There were no significant differences between groups. Two patients in the enalapril group and nine patients in the verapamil group were withdrawn from the study because of adverse effects. The results of this study demonstrate that enalapril and verapamil are well tolerated and effective in the treatment of isolated systolic hypertension in the elderly.
进行了一项前瞻性、研究者设盲的随机研究，以比较依那普利和维拉帕米治疗老年单纯收缩期高血压的疗效和耐受性。在完成研究的115例患者中，58例接受依那普利治疗，57例接受维拉帕米治疗。治疗目标是收缩压<160 mmHg且比基线降低至少20 mmHg。依那普利的初始日剂量为5 mg，维拉帕米为240 mg。剂量逐步增加直至达到目标血压。在滴定期结束时，两组患者的收缩压和舒张压均显著降低（P<0.001）。在8周的维持治疗期内，两组血压仍显著降低（P<0.001）。两组之间无显著差异。依那普利组有2例患者和维拉帕米组有9例患者因不良反应退出研究。本研究结果表明，依那普利和维拉帕米在治疗老年单纯收缩期高血压方面耐受性良好且有效。
