Yodfat Y, Nusbaum M, Gibor Y
Dept. of Family Medicine, Hebrew University-Hadassah Medical School, Jerusalem.
Harefuah. 1991 May 15;120(10):581-4.
The efficacy of sustained release verapamil (Ikapress) was investigated in 237 hypertensive patients of both sexes in a multicenter trial in family practice. There were 4 groups: patients without previous treatment and those treated with nifedipine, with atenolol, or with a combination of drugs. After 4-7 days of washout, all those with diastolic pressures of 95 mm Hg or above received once daily 240 mg of verapamil for 8 weeks. 27 cases had to be withdrawn because of adverse effects: weakness in 10, constipation in 6, rash in 4, impotence in 3, and in 4, other reasons. In 177 blood pressure was brought under control after 4 weeks of treatment. An additional 33 were controlled after 4 weeks of 360 mg of sustained release verapamil. Response to treatment was similar in the 4 trial groups. Mean systolic and diastolic pressures fell 19 and 16 mm Hg, respectively, and mean pulse rate decreased by 5 beats/min. Constipation was the only side-effect reported by those who completed the trial. However, there was a significant reduction in initial scores for headache, dizziness, numbness and edema after 8 weeks of verapamil and all indices of quality of life were significantly improved. These included scores for general well-being, physical fitness, social activity, job fitness, sexual activity, sleep, concentration and mood. Scores for daytime sleepiness and fatigue also decreased significantly. Thus, sustained-release verapamil in a daily dose of 240-360 mg was shown to be an effective antihypertensive. It had few adverse effects and gave considerable improvement in quality of life.
在一项家庭医疗多中心试验中,对237名男女高血压患者研究了缓释维拉帕米(异搏定)的疗效。分为4组:未接受过治疗的患者,以及接受硝苯地平、阿替洛尔或联合用药治疗的患者。经过4 - 7天的洗脱期后,所有舒张压在95毫米汞柱及以上的患者每日服用一次240毫克维拉帕米,持续8周。27例因不良反应退出:10例出现虚弱,6例便秘,4例皮疹,3例阳痿,4例因其他原因。治疗4周后,177例血压得到控制。另外33例在服用360毫克缓释维拉帕米4周后血压得到控制。4个试验组的治疗反应相似。平均收缩压和舒张压分别下降19毫米汞柱和16毫米汞柱,平均脉搏率下降5次/分钟。便秘是完成试验者报告的唯一副作用。然而,维拉帕米治疗8周后,头痛、头晕、麻木和水肿的初始评分显著降低,生活质量的所有指标均显著改善。这些指标包括总体幸福感、身体健康、社交活动、工作适应能力、性活动、睡眠、注意力和情绪评分。日间嗜睡和疲劳评分也显著降低。因此,每日剂量为240 - 360毫克的缓释维拉帕米被证明是一种有效的抗高血压药物。它副作用少,能显著改善生活质量。