Fitscha P, Meisner W, Hitzenberger G
Department of Internal Medicine II, Policlinic, Vienna, Austria.
Am J Hypertens. 1991 Feb;4(2 Pt 2):151S-153S. doi: 10.1093/ajh/4.2.151s.
The antihypertensive effects of isradipine and captopril were studied in 140 patients (70 men) with mild-to-moderate hypertension, aged 26 to 74 years, in a double-blind, randomized, between-patient comparative trial. Initial treatment started with 1.25 mg isradipine twice daily or 12.5 mg captopril twice daily. If normotension was not achieved after four weeks, doses were increased to 2.5 mg twice daily or 25 mg twice daily, respectively. If the maximum dose as monotherapy did not result in normotension, captopril (12.5 mg or, if necessary, 25 mg twice daily) was added to regimens of the isradipine-treated patients or isradipine (1.25 mg or, if necessary, 2.5 mg twice daily) was given in addition to the captopril-treated patients. After 24 weeks of active treatment, systolic blood pressure was significantly reduced (P less than .001) with isradipine (from 168 +/- 18 to 144 +/- 14 mm Hg) and with captopril (from 168 +/- 20 to 143 +/- 10 mm Hg). Diastolic blood pressure also fell significantly (P less than .001) in both groups (isradipine: from 105 +/- 5 to 84 +/- 5 mm Hg; captopril; from 105 +/- 4 to 85 +/- 4 mm Hg). With isradipine as monotherapy, diastolic blood pressure was normalized in 49% of patients compared with 56% with captopril as monotherapy (P = NS). Combining both drugs resulted in an increased rate of normalization (to 87%). The results indicate that combined treatment with a calcium antagonist and an angiotensin-converting enzyme inhibitor is effective in lowering blood pressure and is well tolerated during long-term therapy.
在一项双盲、随机、患者间比较试验中，对140例年龄在26至74岁之间的轻至中度高血压患者（70例男性）研究了伊拉地平与卡托普利的降压效果。初始治疗从每日两次服用1.25毫克伊拉地平或每日两次服用12.5毫克卡托普利开始。如果四周后未达到正常血压，则剂量分别增加至每日两次2.5毫克或每日两次25毫克。如果单药治疗的最大剂量未导致血压正常，则在伊拉地平治疗的患者方案中加用卡托普利（每日两次12.5毫克或必要时每日两次25毫克），或者在卡托普利治疗的患者中加用伊拉地平（每日两次1.25毫克或必要时每日两次2.5毫克）。经过24周的积极治疗后，伊拉地平组（收缩压从168±18降至144±14毫米汞柱）和卡托普利组（收缩压从168±20降至143±10毫米汞柱）的收缩压均显著降低（P＜0.001）。两组的舒张压也均显著下降（P＜0.001）（伊拉地平组：从105±5降至84±5毫米汞柱；卡托普利组：从105±4降至85±4毫米汞柱）。以伊拉地平作为单药治疗时，49%的患者舒张压恢复正常，而以卡托普利作为单药治疗时为56%（P=无显著性差异）。联合使用两种药物使血压恢复正常的比例增加（达到87%）。结果表明，钙拮抗剂与血管紧张素转换酶抑制剂联合治疗在降低血压方面有效，且在长期治疗中耐受性良好。
