Saragoça M A, Portela J E, Plavnik F, Ventura R P, Lotaif L, Ramos O L
Hypertension-Nephrology Institute, Paulista School of Medicine, São Paulo, Brazil.
J Cardiovasc Pharmacol. 1992;19 Suppl 3:S76-8.
In order to investigate the efficacy of isradipine in the treatment of hypertensive crisis, we treated three groups of patients who had diastolic blood pressure (DBP) greater than 120 mm Hg, and who were without signs of acute target-organ damage. Isradipine was given sublingually in doses of 1.25 mg (group 1; n = 10), 2.5 mg (group 2; n = 10), and 5 mg (group 3; n = 7). Mean arterial pressure (MAP) was reduced in all patients [from 153.4 +/- 4.3 to 124.0 +/- 2.3 mm Hg at 60 min, and to 118.0 +/- 2.1 mm Hg at 2 h after administration (p less than 0.001)]. The heart rate (HR) did not change significantly (from 82.4 +/- 3.7 to 84.0 +/- 6 beats/min; NS). No significant differences were noted in the overall responses of the three groups; however, blood pressure reduction was more rapid in the group receiving 5 mg compared with the other two dosages. These results show that isradipine given sublingually is effective in reducing the elevated blood pressure of a hypertensive crisis and is not accompanied by limiting side effects. Isradipine's onset of action is early (approximately 30 min after dosing) and reaches its maximum blood pressure response within 2 h of administration. No dose-dependent reductions in blood pressure were observed with the dosage range employed in this study.
为研究伊拉地平治疗高血压危象的疗效，我们对三组舒张压（DBP）大于120mmHg且无急性靶器官损害体征的患者进行了治疗。伊拉地平分别以1.25mg（第1组；n = 10）、2.5mg（第2组；n = 10）和5mg（第3组；n = 7）的剂量舌下给药。所有患者的平均动脉压（MAP）均降低[给药后60分钟时从153.4±4.3降至124.0±2.3mmHg，2小时时降至118.0±2.1mmHg（p＜0.001）]。心率（HR）无显著变化（从82.4±3.7降至84.0±6次/分钟；无显著性差异）。三组的总体反应未观察到显著差异；然而，与其他两个剂量组相比，接受5mg剂量的组血压降低更快。这些结果表明，舌下含服伊拉地平可有效降低高血压危象时升高的血压，且无明显副作用。伊拉地平起效早（给药后约30分钟），给药后2小时内达到最大血压反应。本研究采用的剂量范围内未观察到剂量依赖性的血压降低。
