Weir M R, Lavin P T
Division of Nephrology, University of Maryland Hospital, Baltimore.
Clin Ther. 1992 Sep-Oct;14(5):730-9.
The efficacy and tolerability of Prinivil and Procardia XL were compared in 135 (67 black, 68 white) patients with mild to moderate uncomplicated essential hypertension. The goal of therapy was to achieve and maintain a supine diastolic blood pressure (SDBP) of > 90 mmHg or a decrease in SDBP > or = 10 mmHg. Patients received Prinivil 10 to 40 mg once daily or Procardia XL 30 to 120 mg once daily during a titration period of 2 to 8 weeks to achieve the goal blood pressure before a 4-week maintenance period. The mean baseline supine systolic/diastolic blood pressures were 151/97 mmHg in patients receiving Prinivil and 153/99 mmHg in patients receiving Procardia XL. Ninety-one percent of patients receiving Prinivil and 95% of those receiving Procardia XL achieved SDBP control at the end of titration therapy. At the end of the maintenance treatment period, 79% of patients receiving Prinivil and 80% of those receiving Procardia XL had SDBP control. Mean decreases in SDBP from baseline were comparable for both treatment groups. At the end of the titration period, mean decreases were 9.6 mmHg in patients receiving Prinivil and 11.3 mmHg in patients receiving Procardia XL; at the end of the maintenance period, mean decreases were 10.8 mmHg and 12.1 mmHg, respectively. There were no differences in treatment responses in either the black or white hypertensive subgroups. Thus both drugs were equally effective in black and white patients with mild to moderate essential hypertension. Both drugs were generally well tolerated, but the number of adverse experiences requiring discontinuation of therapy was significantly higher (P = 0.03) in patients receiving Procardia XL.
对135例（67例黑人、68例白人）轻度至中度单纯性原发性高血压患者比较了雅施达（Prinivil）和络活喜（Procardia XL）的疗效及耐受性。治疗目标是使仰卧位舒张压（SDBP）达到并维持>90 mmHg，或使SDBP降低>或=10 mmHg。在2至8周的滴定期内，患者每日服用一次10至40 mg雅施达或每日服用一次30至120 mg络活喜，以在4周的维持期前达到目标血压。接受雅施达治疗患者的平均基线仰卧位收缩压/舒张压为151/97 mmHg，接受络活喜治疗患者的为153/99 mmHg。滴定治疗结束时，91%接受雅施达治疗的患者和95%接受络活喜治疗的患者实现了SDBP控制。维持治疗期结束时，79%接受雅施达治疗的患者和80%接受络活喜治疗的患者实现了SDBP控制。两个治疗组SDBP较基线的平均降低幅度相当。滴定期结束时，接受雅施达治疗患者的平均降低幅度为9.6 mmHg，接受络活喜治疗患者的为11.3 mmHg；维持期结束时，平均降低幅度分别为10.8 mmHg和12.1 mmHg。黑人或白人高血压亚组的治疗反应无差异。因此，两种药物对轻度至中度原发性高血压的黑人和白人患者同样有效。两种药物总体耐受性良好，但接受络活喜治疗的患者中因不良事件需要停药的人数显著更高（P = 0.03）。
