Belousov Y, Kushnaryov V
Department of Clinical Pharmacology, 2nd Medical Institute, Moscow, USSR.
J Cardiovasc Pharmacol. 1991;18 Suppl 9:S32-5.
In 80 patients with moderate hypertension the effects of nisoldipine 10 mg b.i.d., nifedipine 10 mg and 20 mg t.i.d., diltiazem 60 mg and 120 mg t.i.d., and verapamil 40 mg q.i.d. (all after single dose and 14 days' treatment) on blood pressure; hemodynamic parameters (cardiac output, stroke volume, left ventricular ejection fraction, and total peripheral resistance); and red blood cell and platelet functional state parameters (platelet aggregation, erythrocytal mechanical resistance, and free hemoglobin and ADP levels in plasma) were studied. All of the drugs studied in doses mentioned produced statistically significant hypotensive effects. Nifedipine 20 mg and nisoldipine 10 mg produced the most peripheral vasodilatator activity after a single dose and chronic treatment. Diltiazem had the same effect only in doses of 120 mg and after chronic treatment. However, all the drugs significantly normalized the red blood cell and platelet functional state disturbances in 70-80% of patients with moderate hypertension, even 2 h after a single dose. Disaggregation effect was parallel to clinical improvement. These data make it possible to predict the individual response of most patients to antihypertensive drugs on the basis of acute pharmacological tests, with determination of disaggregation effect.
在80例中度高血压患者中，研究了硝苯地平10毫克每日两次、硝苯地平10毫克和20毫克每日三次、地尔硫䓬60毫克和120毫克每日三次以及维拉帕米40毫克每日四次（均在单次给药和14天治疗后）对血压、血流动力学参数（心输出量、每搏输出量、左心室射血分数和总外周阻力）以及红细胞和血小板功能状态参数（血小板聚集、红细胞机械阻力以及血浆中游离血红蛋白和ADP水平）的影响。所研究的所有药物在所述剂量下均产生了具有统计学意义的降压作用。单次给药和长期治疗后，硝苯地平20毫克和尼索地平10毫克产生的外周血管舒张活性最强。地尔硫䓬仅在120毫克剂量及长期治疗后才有相同效果。然而，所有药物均使70 - 80%的中度高血压患者的红细胞和血小板功能状态紊乱显著恢复正常，甚至在单次给药后2小时即可出现。解聚作用与临床改善情况平行。这些数据使得在急性药理试验中通过测定解聚作用来预测大多数患者对抗高血压药物的个体反应成为可能。
