Mazur N A, Lazareva O N
Kardiologiia. 2008;48(10):4-9.
Aim of the study was comparative assessment of hypotensive, antiischemic efficacy and effect on left ventricular (LV) diastolic function of calcium antagonists, angiotensin converting enzyme inhibitor and blockers of beta-adrenoreceptors.
The data obtained evidence that at monotherapy most pronounced lowering of arterial pressure is observed during use of verapamil CR or amlodipine. Therapy with all studied drugs led to significant decrease of number of episodes of ST-segment depressions, their duration and amplitude during 24 hours. Greatest decrease of frequency of episodes of ST-segment depression was observed during therapy with heart rate reducing calcium antagonists. Disturbed LV diastolic function improved under action of calcium antagonists and beta-adrenoblockers did not change during therapy with angiotensin converting enzyme inhibitor. Diminishment of severity of disturbance of diastolic function under influence of pulse slowing calcium antagonists was associated in the first place with augmentation of LV filling in the first phase of diastole, but during therapy with amlodipine and beta-adrenoblockers - with decrease of contribution of systole of the left atrium. beta-adrenoblockers and diltiazem improved LV diastolic function in patients with episodes of painless myocardial ischemia.
Comparative assessment of hypotensive action of preparations from three groups revealed that greatest lowering of arterial pressure occurred during monotherapy with verapamil SR and amlodipine. The stadied drugs differently affected damage of a target organ - the heart - in patients with AH.
本研究的目的是对钙拮抗剂、血管紧张素转换酶抑制剂和β-肾上腺素能受体阻滞剂的降压、抗缺血疗效以及对左心室(LV)舒张功能的影响进行比较评估。
所获数据表明,在单一疗法中,使用维拉帕米缓释片或氨氯地平时观察到动脉压下降最为显著。使用所有研究药物进行治疗均导致24小时内ST段压低发作次数、发作持续时间和发作幅度显著减少。在使用降低心率的钙拮抗剂进行治疗期间,观察到ST段压低发作频率下降最为明显。在钙拮抗剂的作用下,紊乱的左心室舒张功能得到改善,而在使用血管紧张素转换酶抑制剂进行治疗期间,β-肾上腺素能受体阻滞剂未发生变化。在脉搏减慢的钙拮抗剂影响下,舒张功能障碍严重程度的减轻首先与舒张期第一阶段左心室充盈增加有关,但在使用氨氯地平和β-肾上腺素能受体阻滞剂进行治疗期间,则与左心房收缩贡献的减少有关。β-肾上腺素能受体阻滞剂和地尔硫卓改善了无痛性心肌缺血发作患者的左心室舒张功能。
对三组制剂降压作用的比较评估显示,在使用维拉帕米缓释片和氨氯地平进行单一疗法期间,动脉压下降最为显著。所研究的药物对高血压患者的靶器官——心脏的损害有不同影响。