Eisner G M, Johnson B F, McMahon F G, Rudd P, Sowers J R, Vargas R, Zemel M
Department of Physiology and Medicine, Georgetown University School of Medicine, Washington, D.C.
Am J Hypertens. 1991 Feb;4(2 Pt 2):154S-157S. doi: 10.1093/ajh/4.2.154s.
This multicenter trial compared the efficacy and safety of isradipine and enalapril in 160 patients with essential hypertension. Patients received isradipine or enalapril for 10 weeks after a placebo wash-out period of three to five weeks. Dosage was titrated for six weeks on the basis of blood pressure (BP) response and was then maintained for the remainder of the study. Isradipine reduced systolic and diastolic BP by 12 and 9 mm Hg, respectively, and enalapril by 10 and 7 mm Hg, respectively (between-treatment difference P less than .05 for diastolic BP). Overall, isradipine resulted in a higher responder rate, particularly among patients who had higher entry BPs. Fifteen enalapril-treated patients and four isradipine-treated patients discontinued treatment (four taking enalapril and none taking isradipine withdrew because of lack of efficacy). The most frequently reported adverse reactions were headache, dizziness, and edema in the isradipine group, and cough, headache, and chest pain in the enalapril group. Both drugs produced significant reductions in BP, but, in this study isradipine was more effective. The drugs were similarly well tolerated.
这项多中心试验比较了伊拉地平与依那普利对160例原发性高血压患者的疗效和安全性。在经过三至五周的安慰剂洗脱期后，患者接受伊拉地平或依那普利治疗10周。根据血压（BP）反应调整剂量6周，然后在研究的剩余时间维持该剂量。伊拉地平使收缩压和舒张压分别降低12和9毫米汞柱，依那普利使收缩压和舒张压分别降低10和7毫米汞柱（治疗组间舒张压差异P<0.05）。总体而言，伊拉地平的有效率更高，尤其是在基线血压较高的患者中。15例接受依那普利治疗的患者和4例接受伊拉地平治疗的患者停止治疗（4例服用依那普利的患者因疗效不佳停药，服用伊拉地平的患者无人因疗效不佳停药）。伊拉地平组最常报告的不良反应是头痛、头晕和水肿，依那普利组是咳嗽、头痛和胸痛。两种药物均使血压显著降低，但在本研究中伊拉地平更有效。两种药物的耐受性相似。
