Shankar Pinakini K, Vidyasagar Sudha, Adiga Sachidananda, Naidu M U R, Usha Rani P, Rao Dayasagar, Bairy K L, Nair Sreekumaran, Jayaprakash B, Shashikiran U
Department of Pharmacology, Kasturba Medical College, Manipal.
Indian J Physiol Pharmacol. 2006 Oct-Dec;50(4):421-6.
Several large scale clinical trials have demonstrated that angiotensin converting enzyme inhibitors offer cardiovascular and renal protection independent of their effects on systolic BP. Trandolapril is a new angiotensin converting enzyme inhibitor approved for the treatment of hypertension. The potential advantages of this drug are long duration of action and better tolerability. The objective of the study was to compare the efficacy and tolerability of trandolapril with that of enalapril in mild to moderate hypertension in Indian population. In this double blind, multicentric, parallel comparative clinical study, 120 patients with mild to moderate hypertension were randomly assigned to receive trandolapril 2 mg or enalapril 5 mg once daily for 8 weeks. The attainment of sitting diastolic blood pressure <90 mmHg at the end of 8th week was considered as primary outcome measure and attainment of diastolic blood pressure <90 mmHg or reduction of at least 10 mmHg diastolic blood pressure compared to baseline at any visit was considered as secondary outcome measures. 98.4% patients treated with trandolapril and 92.6% patients treated with enalapril fulfilled the primary outcome measure. 54, 72 and 62% patients on trandolapril and 52, 61 & 64% patients on enalapril fulfilled secondary outcome measure at the end of 2nd, 4th and 8th week respectively. Also trandolapril was better tolerated than enalapril with no significant abnormality in lab parameters.
多项大规模临床试验表明,血管紧张素转换酶抑制剂可提供心血管和肾脏保护作用,且独立于其对收缩压的影响。群多普利是一种新的血管紧张素转换酶抑制剂,已被批准用于治疗高血压。该药物的潜在优势在于作用持续时间长和耐受性更好。本研究的目的是比较群多普利与依那普利在印度人群轻度至中度高血压治疗中的疗效和耐受性。在这项双盲、多中心、平行对照临床研究中,120例轻度至中度高血压患者被随机分配,每天一次接受2毫克群多普利或5毫克依那普利治疗,为期8周。第8周结束时坐位舒张压<90 mmHg被视为主要结局指标,任何一次就诊时舒张压<90 mmHg或与基线相比舒张压至少降低10 mmHg被视为次要结局指标。接受群多普利治疗的患者中有98.4%、接受依那普利治疗的患者中有92.6%达到了主要结局指标。接受群多普利治疗的患者在第2、4和8周结束时分别有54%、72%和62%达到次要结局指标,接受依那普利治疗的患者分别有52%、61%和64%达到次要结局指标。此外,群多普利的耐受性优于依那普利,实验室参数无明显异常。