Luomanmäki K, Inkovaara J, Hartikainen M, Helin M, Viikari J, Kataja M, Ekman K, Harjula K
Department of Medicine, Helsinki University Central Hospital, Finland.
J Cardiovasc Pharmacol. 1992 Aug;20(2):296-303. doi: 10.1097/00005344-199208000-00016.
Eight hundred seventy-six men and women with diastolic blood pressure (DBP) of 95-115 mm Hg during a 4-week placebo period were included in a multicenter trial; 479 patients had previously been treated for hypertension. The patients were randomized to receive isradipine or metoprolol; both groups were comparable for age, weight, height, smoking habits, and duration of hypertension. By the end of the placebo period, 79 patients did not fulfill the final entry criteria and were withdrawn. The isradipine group consisted of 398 patients (164 women and 234 men), and the metoprolol group consisted of 399 patients (173 women and 226 men). The initial dose of isradipine was 1.25 mg twice daily (b.i.d.), and the initial dose of metoprolol was 50 mg b.i.d.; the doses were doubled after 4 weeks if DBP had not decreased to less than or equal to 90 mm Hg. After 8 weeks, the isradipine group began combination therapy with metoprolol 50 mg b.i.d. and the metoprolol group began combination therapy with isradipine 1.25 mg b.i.d. if DBP was not less than or equal to 90 mm Hg. After 8 weeks monotherapy, mean BP (MBP) was reduced by 13/11 mm Hg (161/104 to 148/93) in the isradipine group and by 15/12 mm Hg (160/103 to 145/91) in the metoprolol group. Monotherapy with isradipine normalized DBP to less than or equal to 90 mm Hg in 52% with a mean dose of 4.26 mg daily, and monotherapy with metoprolol normalized DBP in 58% with a mean dose of 155 mg daily.1+
在为期4周的安慰剂期内，舒张压（DBP）为95-115mmHg的876名男性和女性被纳入一项多中心试验；479名患者此前曾接受过高血压治疗。患者被随机分为接受伊拉地平或美托洛尔治疗；两组在年龄、体重、身高、吸烟习惯和高血压病程方面具有可比性。在安慰剂期结束时，79名患者未达到最终入选标准而被撤出。伊拉地平组由398名患者组成（164名女性和234名男性），美托洛尔组由399名患者组成（173名女性和226名男性）。伊拉地平的初始剂量为每日两次（b.i.d.）1.25mg，美托洛尔的初始剂量为每日两次50mg；如果舒张压未降至小于或等于90mmHg，则4周后剂量加倍。8周后，如果舒张压不小于或等于90mmHg，伊拉地平组开始与每日两次50mg美托洛尔联合治疗，美托洛尔组开始与每日两次1.25mg伊拉地平联合治疗。单药治疗8周后，伊拉地平组平均血压（MBP）降低了13/11mmHg（从161/104降至148/93），美托洛尔组降低了15/12mmHg（从160/103降至145/91）。伊拉地平单药治疗使52%的患者舒张压正常化至小于或等于90mmHg，平均每日剂量为4.26mg，美托洛尔单药治疗使58%的患者舒张压正常化，平均每日剂量为155mg。
