Mayer O, Polivkova H, Rottenborn J
Department of Clinical Pharmacology, University Hospital, Pilsen, Czechoslovakia.
Am J Hypertens. 1991 Feb;4(2 Pt 2):140S-143S. doi: 10.1093/ajh/4.2.140s.
After a placebo run-in phase of four weeks' duration, 1.25 mg or 2.5 mg isradipine twice daily orally was administered for one year to 23 patients who had been diagnosed as hypertensive. Good control of blood pressure was recorded in the majority of patients until the third month of treatment. After five months, it was necessary to add a beta-blocker to the treatment regimens of some of the patients in order to maintain the target blood pressure of 140/90 mm Hg. Patients were exercise-tested using bicycle ergometry. After three months, diastolic blood pressure was significantly lower during exercise when comparing the treatment values with those taken at the end of the placebo run-in (baseline values). Values for systolic blood pressure did not differ between treatment and baseline. These results may be explained by the decrease in peripheral vascular resistance produced by isradipine. After one year, the results were modified by the administration of the beta-blocker bopindolol (Sandonorm, Sandoz Pharma Ltd., Basle, Switzerland). Total cholesterol, high-density lipoprotein cholesterol, and apolipoprotein B levels did not change during treatment. Triglycerides were lower after three months, but slightly higher after one year, with an average value lying within the normal range. The influence of isradipine on plasma renin activity (PRA) and aldosterone levels was followed by measuring values at rest and during exercise. It was found that PRA was higher during the first three months, then inversely inhibited to lower levels. Aldosterone levels were also increased after three months, but without a subsequent decrease. The results are compared with those obtained with diltiazem in a similar treatment regimen.
在为期四周的安慰剂导入期后，对23名已被诊断为高血压的患者口服伊拉地平，每日两次，每次1.25毫克或2.5毫克，持续一年。在治疗的前三个月，大多数患者的血压得到了良好控制。五个月后，有必要在部分患者的治疗方案中加用β受体阻滞剂，以维持140/90毫米汞柱的目标血压。采用自行车测力计对患者进行运动测试。三个月后，将治疗期间的值与安慰剂导入期结束时（基线值）测得的值进行比较，运动期间的舒张压显著降低。治疗组与基线组的收缩压值无差异。这些结果可能是由伊拉地平引起的外周血管阻力降低所解释的。一年后，因加用β受体阻滞剂波吲洛尔（Sandonorm，山德士制药有限公司，瑞士巴塞尔）而使结果有所改变。治疗期间总胆固醇、高密度脂蛋白胆固醇和载脂蛋白B水平未发生变化。甘油三酯在三个月后降低，但在一年后略有升高，平均值在正常范围内。通过测量静息和运动时的值，跟踪伊拉地平对血浆肾素活性（PRA）和醛固酮水平的影响。发现PRA在最初三个月较高，随后被反向抑制至较低水平。醛固酮水平在三个月后也升高，但随后没有下降。将这些结果与在类似治疗方案中使用地尔硫卓所获得的结果进行比较。
