Marchais S J, Boussac I, Guerin A P, Delavaux G, Metivier F, London G M
Centre Hospitalier F. H. Manhes Fleury-Mérogis, France.
J Cardiovasc Pharmacol. 1991;18 Suppl 5:S14-8.
The relationship between the presence of arterial calcinosis and the antihypertensive response to calcium blockers was studied in 40 hypertensive patients with end-stage renal failure (ESRF) on chronic hemodialysis, before and during 16 weeks after administration of nitrendipine in monotherapy. In a double-blind, placebo-randomized study, nitrendipine reduced systolic blood pressure regardless of the presence or absence of arterial calcifications. The antihypertensive effects were significantly more pronounced in subjects with aortic calcium deposits in comparison with patients without clinical signs of arteriosclerosis (p less than 0.01). Diastolic blood pressure was significantly reduced only in patients with aortic calcifications, and remained unchanged in subjects with noncalcified aorta. Aortic pulse wave velocity decreased significantly in patients with aortic calcifications (p less than 0.001), but remained unaffected in patients with noncalcified vessels. Multivariate regression analysis showed that antihypertensive action of nitrendipine was correlated with the presence of aortic calcium deposits independently of age or baseline blood pressure levels. The results of the present study indicate that an overt arteriosclerosis as demonstrated by the presence of aortic calcifications on abdominal radiographs is a good indication for use of dihydropiridines in patients with ESRF.
在40例接受慢性血液透析的终末期肾衰竭（ESRF）高血压患者中，研究了动脉钙化的存在与对钙通道阻滞剂降压反应之间的关系，研究时间为单药使用尼群地平之前以及用药后16周期间。在一项双盲、安慰剂随机研究中，无论有无动脉钙化，尼群地平均可降低收缩压。与无动脉硬化临床体征的患者相比，有主动脉钙沉积的受试者降压效果明显更显著（p<0.01）。仅主动脉钙化患者的舒张压显著降低，无钙化主动脉的受试者舒张压无变化。主动脉钙化患者的主动脉脉搏波速度显著降低（p<0.001），但血管未钙化的患者不受影响。多因素回归分析表明，尼群地平的降压作用与主动脉钙沉积的存在相关，与年龄或基线血压水平无关。本研究结果表明，腹部X线片显示的明显动脉硬化，即主动脉钙化，是ESRF患者使用二氢吡啶类药物的良好指征。
