Varrone J
Pfizer International Inc., New York, NY 10017.
Postgrad Med J. 1991;67 Suppl 5:S28-31.
Three hundred and twenty hypertensive out-patients were recruited to this multicentre general practice study of the efficacy and safety of amlodipine. Patients with baseline sitting diastolic blood pressure in the range 95-115 mmHg at two consecutive visits went on to a 12-week active treatment phase of the study. In this study, patients received open-label amlodipine at a starting dose of 5 mg/day, which could be adjusted after 4 weeks to 10 mg/day if necessary to achieve a sitting diastolic blood pressure of less than or equal to 90 mmHg. Amlodipine produced significant (P less than 0.05) blood pressure reductions throughout the study without significant changes in heart rate. The exposure to amlodipine in this study was 873 patient months. Most adverse events were mild or moderate and the investigators' overall evaluation of tolerability was excellent or good for 91% of patients. The most frequently reported adverse events were oedema (13.8%), headache (7.8%) and rashes (3.8%). Analysis of data for subgroups of patients confirmed that there were no important differences in the efficacy and tolerability of amlodipine in elderly or young patients and in patients taking amlodipine as monotherapy or in combination with other antihypertensive agents. This uniformity of response is clearly an important factor in consideration of antihypertensive therapy use in general practice.
320名高血压门诊患者被纳入这项关于氨氯地平疗效和安全性的多中心全科医学研究。在连续两次就诊时,静息舒张压基线值在95 - 115 mmHg范围内的患者进入为期12周的研究积极治疗阶段。在本研究中,患者接受开放标签的氨氯地平治疗,起始剂量为5 mg/天,如有必要,4周后可调整至10 mg/天,以实现静息舒张压小于或等于90 mmHg。在整个研究过程中,氨氯地平使血压显著降低(P < 0.05),心率无显著变化。本研究中氨氯地平的暴露时间为873患者月。大多数不良事件为轻度或中度,研究者对91%患者的耐受性总体评价为优或良。最常报告的不良事件为水肿(13.8%)、头痛(7.8%)和皮疹(3.8%)。对患者亚组数据的分析证实,氨氯地平在老年或年轻患者中,以及在接受氨氯地平单药治疗或与其他抗高血压药物联合治疗的患者中,疗效和耐受性均无重要差异。这种反应的一致性显然是在全科医学中考虑使用抗高血压治疗时的一个重要因素。