Agabiti Rosei Enrico, Morelli Patrizia, Rizzoni Damiano
Chair of Internal Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.
Blood Press Suppl. 2005 Jul;1:14-22. doi: 10.1080/08037050510034257.
Calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors and other drug classes either alone or in combination have been recommended for the treatment of hypertension. Nifedipine gastrointestinal therapeutic system (GITS) 20 mg is a new low-dose formulation with an improved tolerability. The aim of the present study was to compare the effects of nifedipine GITS 20 mg and enalapril 20 mg on blood pressure and circulating adhesion molecules in hypertensive patients.
This randomized, double-blind, multicentre trial compared the blood pressure lowering effects of a 12-week treatment of nifedipine GITS 20 mg vs enalapril 20 mg in 264 patients with mild-to-moderate hypertension.
Nifedipine GITS 20 mg induced a reduction of clinic blood pressure, which was similar to that observed with enalapril 20 mg. Nifedipine GITS and enalapril lowered mean sitting diastolic blood pressure by 11.8 and 12.4 mmHg, respectively, while systolic blood pressure was reduced by 15.3 and 16.3 mmHg, respectively. Ambulatory blood pressure monitoring-derived blood pressure data showed similar results in both groups without any statistically significant differences between treatments. Both enalapril and nifedipine tended to reduce ICAM-1 and E-selectin, while only nifedipine reduced von Willebrand factor. Both treatments were well tolerated.
Our findings demonstrate a similar antihypertensive effectiveness of a low dose (20 mg) of nifedipine GITS in comparison with a standard dose of enalapril (20 mg). Given its clinical efficacy and good tolerability, low-dose nifedipine GITS may be considered a valuable treatment option for hypertensive patients.
钙拮抗剂、血管紧张素转换酶（ACE）抑制剂及其他药物类别单独或联合使用均已被推荐用于治疗高血压。硝苯地平胃肠道治疗系统（GITS）20毫克是一种耐受性有所改善的新型低剂量制剂。本研究的目的是比较硝苯地平GITS 20毫克与依那普利20毫克对高血压患者血压及循环黏附分子的影响。
这项随机、双盲、多中心试验比较了264例轻至中度高血压患者接受12周硝苯地平GITS 20毫克与依那普利20毫克治疗后的降压效果。
硝苯地平GITS 20毫克可使诊室血压降低，与依那普利20毫克的降压效果相似。硝苯地平GITS和依那普利分别使平均坐位舒张压降低11.8和12.4毫米汞柱，收缩压分别降低15.3和16.3毫米汞柱。动态血压监测得出的血压数据显示两组结果相似，治疗之间无任何统计学显著差异。依那普利和硝苯地平均倾向于降低细胞间黏附分子-1（ICAM-1）和E-选择素，而只有硝苯地平降低血管性血友病因子。两种治疗的耐受性均良好。
我们的研究结果表明，低剂量（20毫克）硝苯地平GITS与标准剂量依那普利（20毫克）相比具有相似的降压效果。鉴于其临床疗效和良好的耐受性，低剂量硝苯地平GITS可被视为高血压患者的一种有价值的治疗选择。
